cssi/SciSciGPT-SciSciNet huggingface dataset:
Magnetic Resonance Imaging-Guided High-Dose Rate Brachytherapy for Cervical Cancer.

Introduction Cervical cancer represents 0.8% of all new cancer cases and in 2012 there was an estimated 249,512 women living with cervical cancer in the United States. Concurrent chemoradiation followed by brachytherapy represents the standard of care in patients with International Federation of Gynecology and Obstetrics stage IB2 to IVA tumors (tumors larger than 4 cm or with parametrial involvement). During the first phase of treatment, patients receive external beam radiotherapy (EBRT) to the pelvis specifically targeting the cervix, uterus, and regional lymphatics. Patients typically receive 45-50.4 Gy with concurrentweekly cisplatin over 5weeks. This is followed by brachytherapy where applicators are placed in close proximity to the tumor typically via an intracavitary approach for temporary loading of a radioactive source. Brachytherapy plays a crucial role in the management of invasive cervical cancer. It has a rapid dose fall off allowing the tumor to receive a high dose while relatively sparing nearby structures such as the bladder, sigmoid, and rectum. Brachytherapy delivery options have evolved over time and can be delivered through multiple (typically 5) outpatient procedures using a high–dose rate source or during 2 inpatient stays using a low–dose rate source. By taking advantage of the geometric andphysical properties of brachytherapy, the central principle is to escalate the tumor dose to a curative rangewhileminimizing the dose and toxicity to the surrounding organs at risk (rectum, bladder, and sigmoid). Over time with advances in imaging, brachytherapy treatment planning has evolved tomeet these goals. In the early era, brachytherapy was planned using 2-dimensional images (Fig. 1). Defined points in space were used to evaluate the quality of brachytherapy implants and to estimate the tumor dose and dose to organs at risk. With the widespread use of computed tomography (CT) within radiation oncology departments, CT-based planning (Fig. 2) is now feasible. The
A transparent case for subjectivism

N The Subjective View (Oxford, the Clarendon Press, 1983, pp. 35-7), Colin McGinn maintains that 'the impossibility of transparent white ... is just that nothing could look transparent and white'. He goes on to maintain that something's looking white cannot be explicated in objectivist terms, i.e. terms which refer only to the properties and states of physical objects. He argues for his account by rejecting an alternative, objectivist analysis, which he expresses in this way: 'For a surface to be transparent is for it to let through the incident light, whereas for it to be white is for it to reflect all of the light; so transparent white is impossible because a surface cannot simultaneously interact in both these ways with the light incident upon it.' Here is McGinn's argument against this plausible analysis:
The Effect Analysis of Tuberculosis Control Project Loaned by World Bank in Shiyan Between 1993—2001

OBJECTIVE To evaluate the effect of tuberculosis control project loaned by World Bank(WBLP)in Shiyan. METHODS Collect and analyze the investigation materials and the project guarterly report and annual report in the period during 1993—2001. RESULTS The above program had been conducted wide spreadly since 1993. Over the past nine years,37 673 cases of suspicious tuberculosis patients have been received and diagnosed,in which 13 336 infectious patients(containing 10 060 newlyattacked infectious patients)were found until December 2001. The number of average annual registered infectious patients are 5.1 times that of the project prior 10 years in WBLP.And the average cure rate of infectious patients reached to 95.04%.The cure rate showed an uptrend amounting to 95.04% from 77.68%. CONCLUSION Satisfactory results have been achieved of infectious disease control project loaned by World Bank in Shiyan.
Species-specific effects of earthworms on microbial communities and the fate of litter-derived carbon

Abstract Soil respiration is frequently measured as a surrogate for biological activities and is important in soil carbon cycling. The heterotrophic component of soil respiration is primarily driven by microbial decomposition of leaf litter and soil organic matter, and is partially controlled by resource availability. In North American temperate deciduous forests, invasive European and Asian earthworms are known to variously affect soil properties and resource availability through their feeding, burrowing, and casting behaviors, and may affect different components of soil respiration through modulating the microbial communities. By tracing litter-derived C from 13C and 15N double-enriched leaf litter into soil and CO2 efflux in a mesocosm experiment, we tested the hypothesis that earthworms inhibit litter C-derived soil respiration by reducing resource availability and microbial biomass, and further examined how species-specific effects of earthworms on soil respiration are mediated by soil microbial community. We showed that while earthworms generally had no effect on total soil respiration, the interaction between Octolasion lacteum and Lumbricus rubellus had a significant negative non-additive effect, presumably through affecting anaerobic microsites in the soil. Moreover, litter C-derived soil respiration was reduced by the Asian Amynthas hilgendorfi, the European L. rubellus, and the North American native species Eisenoides lonnbergi, but not by the European species O. lacteum. Phospholipid fatty acid (PLFA) analysis and structural equation modeling indicated that while soil bacteria and fungi abundances were affected by earthworm species identities, the observed reduction of litter C-derived soil respiration could not be fully explained by changes in microbial biomass. We attributed these effects to earthworm-induced aggregate formation, reduction of microbial transformation of labile carbon, and antimicrobial peptide activities, and concluded that the mechanisms through which the four earthworm species affect the fate of litter-derived C and its mineralization are species-specific.
Introduction: Systems Engineering—Why?

The purpose of this text book is to arm the student with System Engineering principles, practices, and activities applicable to developing programs and systems within today’s complex, distributed multi-discipline converging enterprise environments. Specifically, the focus is to match the overwhelming design gaps and needs of the current Systems Engineering discipline with foundations of new and relevant procedures, products and implements. Therefore, this introductory text book provides the basis for a modern Multi-disciplinary Systems Engineering approach.
Radiative Property Predictions From Electromagnetic Wave Theory

The basic radiative properties of surfaces forming an enclosure, i.e., emissivity, absorptivity, reflectivity, and transmissivity, must be known before any radiative heat transfer calculations can be carried out. Many of these properties vary with incoming direction, outgoing direction, and wavelength, and must usually be found through experiment. However, for pure, perfectly smooth surfaces these properties may be calculated from classical electromagnetic wave theory. 1 These predictions make experimental measurements unnecessary for some cases, and help interpolating as well as extrapolating experimental data in many other situations.
Information Architecture and the Comic Arts: Knowledge Structure and Access

AbstractThis article explains information architecture, focusing on comic arts’ features for representing and structuring knowledge. Then it details information design theory and information behaviors relative to this format, also noting visual literacy. Next , applications of comic arts in education are listed. With this background, several research methods that combine information design and comic arts are explained, followed by a concrete research example. It also recommends strategies for addressing information architecture explicitly for knowledge acquisition and communication.
Rotating lattice single crystal architecture on the surface of glass

Defying the requirements of translational periodicity in 3D, rotation of the lattice orientation within an otherwise single crystal provides a new form of solid. Such rotating lattice single (RLS) crystals are found, but only as spherulitic grains too small for systematic characterization or practical application. Here we report a novel approach to fabricate RLS crystal lines and 2D layers of unlimited dimensions via a recently discovered solid-to-solid conversion process using a laser to heat a glass to its crystallization temperature but keeping it below the melting temperature. The proof-of-concept including key characteristics of RLS crystals is demonstrated using the example of Sb2S3 crystals within the Sb-S-I model glass system for which the rotation rate depends on the direction of laser scanning relative to the orientation of initially formed seed. Lattice rotation in this new mode of crystal growth occurs upon crystallization through a well-organized dislocation/disclination structure introduced at the glass/crystal interface. Implications of RLS growth on biomineralization and spherulitic crystal growth are noted.
Inflammation Effects on Brain Glutamate in Depression: Mechanistic Considerations and Treatment Implications

There has been increasing interest in the role of glutamate in mood disorders, especially given the profound effect of the glutamate receptor antagonist ketamine in improving depressive symptoms in patients with treatment-resistant depression. One pathway by which glutamate alterations may occur in mood disorders involves inflammation. Increased inflammation has been observed in a significant subgroup of patients with mood disorders, and inflammatory cytokines have been shown to influence glutamate metabolism through effects on astrocytes and microglia. In addition, the administration of the inflammatory cytokine interferon-alpha has been shown to increase brain glutamate in the basal ganglia and dorsal anterior cingulate cortex as measured by magnetic resonance spectroscopy (MRS). Moreover, MRS studies in patients with major depressive disorder have revealed that increased markers of inflammation including C-reactive protein correlate with increased basal ganglia glutamate, which in turn was associated with anhedonia and psychomotor retardation. Finally, human and laboratory animal studies have shown that the response to glutamate antagonists such as ketamine is predicted by increased inflammatory cytokines. Taken together, these data make a strong case that inflammation may influence glutamate metabolism to alter behavior, leading to depressive symptoms including anhedonia and psychomotor slowing.
Early versus late inguinal hernia repair in extremely low-birthweight infants.

AbstractObjective: Compare outcomes of extremely low-birthweight (ELBW) infants following early (before discharge) versus late (after discharge) inguinal hernia (IH) repair.Study design: In a retrospective study of ELBW infants with IH, data were abstracted for clinical characteristics, IH and related outcomes.Result: Of the 39/252 (15.4%) ELBW infants who developed IH, those with early (59%) versus late (41%) repair were comparable in birth weight (753 ± 158 versus 744 ± 131 g, p = 0.84), gestation age (26 ± 2 versus 26.2 ± 2 weeks, p = 0.92), with comparable rate of broncopulmonary dysplasia (87% versus 75%, p = 0.41), but early repair group had prolonged respiratory support (60.6 ± 28.6 versus 39 ± 30 days, p = 0.032). Both groups had comparable diagnosis to repair interval (51.2 ± 29.2 versus 60.5 ± 30.6 days, p = 0.38) and early repair group has earlier corrected gestation (41.6 ± 3.9 versus 45.4 ± 4.6 weeks, p < 0.01) at time of repair. Post-IH repair complications (incarceration, postoperative apne...
Writing After Nature: A Sebaldian Ecopoetics

Although the melancholic disposition of Sebald’s narrators can threaten to engulf the narrative in a temporal stasis, texts ranging from the long poem After Nature to the travelog The Rings of Saturn are open to a futurity that should be of interest to critical ecological thought. This chapter reads sites of disturbance in Sebald’s writing as novel environments rather than merely the ongoing devastation of a traumatic past. The reduced ecologies of weeds and ruderals that comprise Sebald’s environmental imagination subtly celebrate the regenerative capacities of anthropogenic and non-anthropogenic ecological disturbances (storms, volcanoes, fires, and floods), they nourish a more-than-human future beyond the legacy of anthropogenic destruction, and they also yield an ecopoetics not predicated on an unpolluted atmosphere or unalienated life.
Techniques of Quantitative Measurement of Morphological Structures of the Central Nervous System

The title of this chapter is borrowed from a well-known chapter written by Samuil M. Blinkov and Il’ya Glezer in 1968. Perusal of Blinkov and Glezer’s work is an excellent means of appreciating the changes in human neuropsychology that have been introduced by the wide availability of high-quality in vivo images of the brain. The techniques Blinkov and Glezer described involved calculation of measurements of brain morphology from serial brain sections or casts of brain structures. Measures based on radiographic techniques receive scant attention; CT and MRI, of course, are not mentioned at all.
What you wish for is not what you expect: Measuring hope for peace during intractable conflicts

Abstract Protracted intergroup conflicts, like the Israeli-Palestinian conflict, are often referred to as intractable. Intractable conflicts are termed as such, partly because group members mired in these disputes believe that the conflict is inherently irreconcilable. To better understand the nature of the perceived irreconcilability of intractable conflicts, Jewish-Israelis’ hope for peace was surveyed capturing three interdependent but discrete components of hope: wish for peace, expectations that peace will materialize, and affective hopefulness. To operationalize peace, three definitions of peace, gradually refining from non-concrete to concrete, were offered to respondents ( N = 120). Results reveal that expectations for peace among Jewish-Israelis are low but stable across the three definitions of peace while wishes for peace are higher, more dynamic and, for those with right-wing political orientation, highly dependent on the definition of peace provided. The more concrete the definition, the less rightists wish for peace. Further analysis shows that rightwing leaning respondents exhibit lower wishes for peace, even when the respondent is free to determine what peace might entail. By utilizing novel methods to detect nuances in the dynamics of hope and hopelessness, this study demonstrates that expectation for peace and wishes for peace function in distinct ways during protracted intergroup conflicts.
Reform and Innovation in Science Teaching: A Human Constructivist View

Publisher Summary This chapter describes the origins of a human constructivist model of science teaching that can serve as an alternative to the hunches, guesses, and folklore that have guided the teaching profession for over 100 years. The final report of the Committee of Ten is one of the most remarkable documents in the history of American education. It represents for the first time that university-based scientists contributed substantially to the emerging debate on what schools teach and how they teach it. Recognizing that conceptual change often involves the extremely time-consuming process of negotiation has significant implications for curriculum and instruction. For one thing, it means that fewer topics can be covered in the course of a typical school year, and that great care needs to be taken in selecting and sequencing the concepts in a science curriculum. Increasingly, talented science teachers are being asked to take an active part in the selection of curricula, textbooks, and instructional materials. Rather than passive recipients of district-mandated curriculum guides and teacher-proof kits, these teachers are playing a central role in important decisions about curriculum and instruction.
Variation by stage in the effects of prediagnosis weight loss on mortality in a prospective cohort of esophageal cancer patients.

Cancer cachexia is increasingly recognized as a poor prognostic marker for various tumor types. Weight loss in esophageal cancer is multifactorial, as patients with bulky tumors also have reduced ability to eat. We aimed to investigate the relationship between prediagnosis weight loss and mortality in esophageal cancer and to determine whether these associations vary with tumor stage. We conducted a prospective cohort study of esophageal cancer patients at two tertiary centers. We recorded baseline patient characteristics including medications, smoking, body mass index, and weight loss in the year prior to diagnosis, and collected data on treatment and outcomes. We used Cox regression modeling to determine the associations between percent weight loss and outcomes. The main outcome of interest was all-cause mortality; secondary endpoints were esophageal cancer-specific mortality and development of metastases. We enrolled 134 subjects, the majority of whom had adenocarcinoma (82.1%); median percent weight loss was 4.7% (IQR: 0%-10.9%). Increasing percent weight loss was not associated with all-cause mortality (ptrend = 0.36). However, there was evidence of significant interaction by tumor stage (p = 0.02). There was a strong and significant association between prediagnosis weight loss and mortality in patients with T stages 1 or 2 (adjusted HR 8.26 for highest versus lowest tertile, 95%CI 1.11-61.5, ptrend = 0.03) but not for T stages 3 or 4 (ptrend = 0.32). Body mass index one year prior to diagnosis was not associated with mortality. Prediagnosis weight loss was associated with increased all-cause mortality only in patients with early stage esophageal cancer. This suggests that tumor-related cachexia can occur early in esophageal cancer and represents a poor prognostic marker.
Venom phenotypes of the Rock Rattlesnake (Crotalus lepidus) and the Ridge-nosed Rattlesnake (Crotalus willardi) from México and the United States.

Although the Mexican Highlands has the highest diversity of small-bodied rattlesnakes in the world, studies on the species found throughout this region have been relatively scarce. This has led to challenges with examining venom phenotypic characteristics, as well as species misidentifications and misclassifications. In the current study we investigated venom variation among four subspecies of Crotalus lepidus (C. l. klaluberi, C. l. lepidus, C. l. maculosus, C. l. morulus) and four subspecies of C. willardi (C. w. amabilis, C. w. obscurus, C. w. silus, and C. w. willardi) that inhabit regions of southwestern United States and central Mexico. SDS-PAGE patterns show the presence of many of the major compounds found in other rattlesnake venoms, although minor variations in protein banding patterns and intensity are recognizable. Most notably, PI-metalloproteinase (SVMP) bands appear to be very faint to absent in northern C. l. lepidus and C. l. klauberi subspecies, but are fairly prominent in all other C. lepidus and C. willardi subspecies. Enzyme activity assays revealed that C. lepidus subspecies exhibit higher SVMP and thrombin-like activities when compared to C. willardi subspecies. Significant differences between subspecies were also observed for kallikrein-like serine protease, L-amino acid oxidase, and phosphodiesterase activities, although these differences appear to be random and fail to follow a geographical or phylogenetic trend. The same relationship was also observed for fibrinogenolytic and coagulation assays. Toxicity assays conducted on lab mice (Mus musculus), house geckos (Hemidactylus frenatus), and house crickets (Acheta domestica) revealed varying toxicities between subspecies, with C. l klauberi being the most toxic towards mice (LD50 = 1.36 μg/g) and house geckos (LD50 = 0.17 μg/g), and C. w. silus being most toxic to house crickets (LD50 = 1.94 μg/g). These results provide additional evidence that geographical isolation, natural selection, and adaptive evolution in response to diets may be driving forces contributing to population-level variation in venom composition.
International collaboration in nuclear waste solidification

A number of collaborative research projects between Belgium, Canada, France, Japan, Sweden, Switzerland, the United States, and the Federal Republic of Germany are now in progress to test the relative surface reactions or nuclear waste glasses under a wide variety of simulated repository conditions. The studies include 1-, 3-, 6-, 12-, 24-, and 32-month deep burial in granite boreholes in the Stripa mine in Sweden at 90 and 10/sup 0/C. Nearly 2000 interactive interfaces are being studied in salt in the Waste Isolation Pilot Plant site in the United States. Several glasses from these tests are also being evaluated in clay in Belgium. Comparisons of the simulated burial conditions with glasses containing radioactivity close to that expected for commercial operations as LaHague, France, are being made by a Japan-Sweden-Switzerland consortium with collaboration from the Commissariat a l'Energie Atomique, Marcoule and the Hahn Meitner Institute, Berlin. These studies are leading toward an international consensus on the relative performance of high-level waste forms including borosilicate glasses, waste packages, and repository variables.
Total Synthesis of Lycoricidine and Narciclasine by Chemical Dearomatization of Bromobenzene

The total synthesis of lycoricidine and narciclasine is enabled by an arenophile-mediated dearomative dihydroxylation of bromobenzene. Subsequent transpositive Suzuki coupling and cycloreversion deliver a key biaryl dihydrodiol intermediate, which is rapidly converted into lycoricidine through site-selective syn-1,4-hydroxyamination and deprotection. The total synthesis of narciclasine is accomplished by the late-stage, amide-directed C-H hydroxylation of a lycoricidine intermediate. Moreover, the general applicability of this strategy to access dihydroxylated biphenyls is demonstrated with several examples.
Training Translational Scholars within Family Science Programs

This article addresses issues related to the training of translational scholars in family science (FS) graduate programs. The article advances the view that (a) FS students need more direct socialization on how to message about and market the brand of their programs and (b) the FS brand should be organized around the centrality of translational expertise as one of the core goals of the training mission of FS programs. The article goes on to suggest that the training of translational scholars in FS programs should be organized around two interrelated initiatives. The first involves introducing coursework that balances the focus on the production of scholarship with a focus on the translation of this scholarship into policy and practice. The second is for FS programs to build their capacity to train translational scholars by creating “learning laboratories” in partnership with other health and social service programs, with the explicit goal of advancing collaborative practice and promoting interdisciplinary, multidisciplinary, transdisciplinary, and translational scholarship.
Large-Eddy Simulation and Analysis of Turbulent Flows in a Motored Spark-Ignition Engine

The authors acknowledge that we have used the published engine setup and PIV experimental data of the TCC-III engine. The TCC engine work has been funded by General Motors University of Michigan Automotive Cooperative Research Laboratory, Engine Systems Division. The authors appreciate the comments of Prof. Volker Sick from University of Michigan in regard to the engine setup.
Gordon Newkirk’s Contributions to Coronal Studies

Gordon Allen Newkirk, Jr. was born in West Orange, New Jersey June 12, 1928 and died in Boulder, Colorado December 21, 1985 at age 57. He was graduated from Harvard University in 1950 and in 1953 earned a Ph.D. in astrophysics from the University of Michigan. In 1955, after service in the Signal Corps of the U.S. Army he took a position at the High Altitude Observatory in Boulder where he worked the remaining thirty years of his life. For 11 of those years (1968–1979) he was director of the observatory and associate director of the National Center for Atmospheric Research. He was also active as a teacher and from 1965 through 1985 was an adjoint professor at the University of Colorado. From 1972 through 1975 he served as Chairman of the Solar Physics Division of the American Astronomical Society and from 1976 through 1979 as President of Commission 10 (Solar Activity) of the International Astronomical Union.
Postnatal ablation of synaptic retinoic acid signaling impairs cortical information processing and sensory discrimination in mice

Retinoic acid (RA) and its receptors (RARs) are well established essential transcriptional regulators during embryonic development. Recent findings in cultured neurons identified an independent and critical post-transcriptional role of RA and RARα in the homeostatic regulation of excitatory and inhibitory synaptic transmission in mature neurons. However, the functional relevance of synaptic RA signaling in vivo has not been established. Here, using somatosensory cortex as a model system and the RARα conditional knock-out mouse as a tool, we applied multiple genetic manipulations to delete RARα postnatally in specific populations of cortical neurons, and asked whether synaptic RA signaling observed in cultured neurons is involved in cortical information processing in vivo Indeed, conditional ablation of RARα in mice via a CaMKIIα-Cre or a layer 5-Cre driver line or via somatosensory cortex-specific viral expression of Cre-recombinase impaired whisker-dependent texture discrimination, suggesting a critical requirement of RARα expression in L5 pyramidal neurons of somatosensory cortex for normal tactile sensory processing. Transcranial two-photon imaging revealed a significant increase in dendritic spine elimination on apical dendrites of somatosensory cortical layer 5 pyramidal neurons in these mice. Interestingly, the enhancement of spine elimination is whisker experience-dependent as whisker trimming rescued the spine elimination phenotype. Additionally, experiencing an enriched environment improved texture discrimination in RARα-deficient mice and reduced excessive spine pruning. Thus, RA signaling is essential for normal experience-dependent cortical circuit remodeling and sensory processing.SIGNIFICANCE STATEMENT The importance of synaptic RA signaling has been demonstrated in in vitro studies. However, whether RA signaling mediated by RARα contributes to neural circuit functions in vivo remains largely unknown. In this study, using a RARα conditional knock-out mouse, we performed multiple regional/cell-type-specific manipulation of RARα expression in the postnatal brain, and show that RARα signaling contributes to normal whisker-dependent texture discrimination as well as regulating spine dynamics of apical dendrites from layer (L5) pyramidal neurons in S1. Deletion of RARα in excitatory neurons in the forebrain induces elevated spine elimination and impaired sensory discrimination. Our study provides novel insights into the role of RARα signaling in cortical processing and experience-dependent spine maturation.
L-statistics of absolute differences for quantifying the agreement between two variables

In many clinical studies, Lin’s (1989) concordance correlation coefficient (CCC) is a popular measure of agreement for continuous outcomes. Most commonly, it is used under the assumption that data ...
Comprehensive approaches to prevent adolescent drinking and related problems.

A number of single component strategies have proven effective at reducing underage drinking (Komro & Toomey, 2002). Some of these strategies include interactive classroom curricula driven by the social influences model [e.g., Life Skills Training (Botvin, Baker, Dusenbury, Botvin, & Diaz, 1995)], parenting programs that emphasize skill development [e.g., Strengthening Families Program: For Parents and Youth 10-14 (Spoth, Redmond, & Lepper, 1999)], and public policies that reduce the availability of alcohol [e.g., minimum legal drinking age (Wagenaar & Toomey, 2000)l. The effects of these strategies alone, however, are often limited in duration and scope. Few classroom curricula, for example, have been able to achieve long-term reductions in alcohol use (Komro & Toomey, 2002), and the success of alcohol-related policies appears to be constrained by modest enforcement levels (Wagenaar & Wolfson, 1994). Therefore, in order to achieve a more substantial and sustained intervention effect, an increasingly adopted approach to prevention over the last decade has been the use of more comprehensive strategies that combine two or more of these single components into a multiple component intervention. To date, most multiple component alcohol prevention interventions have combined a classroom curriculum with other strategies that better address the social environment of youth, like school-wide climate change programs, mass media, parent programs, and/or community organizing (Flay, 2000). The pur-
Assignment Exchanges

We analyze "assignment exchanges"- auction and exchange mechanisms which are tight simplifications of direct Walrasian exchange mechanisms. These simplifications are distinguished by their use of assignment messages, which parameterize certain substitutable preferences. The "basic" assignment exchanges respect integer constraints, generalizing the Shapley-Shubik mechanism for indivisible goods. Connections are reported between the assignment exchanges, ascending multi-product clock auctions, uniform price auctions for a single product, and Vickrey auctions. The exchange mechanisms accommodate bids by buyers, sellers and swappers and can support trading for certain kinds of complementary goods.
Feedback With Performance Metric Scorecards Improves Resident Satisfaction but Does Not Impact Clinical Performance.

Objectives The Emergency Medicine Milestone Project, a framework for assessing competencies, has been used as a method of providing focused resident feedback. However, the emergency medicine milestones do not include specific objective data about resident clinical efficiency and productivity, and studies have shown that milestone-based feedback does not improve resident satisfaction with the feedback process. We examined whether providing performance metric reports to resident physicians improves their satisfaction with the feedback process and their clinical performance. Methods We conducted a three-phase stepped-wedge randomized pilot study of emergency medicine residents at a single, urban academic site. In phase 1, all residents received traditional feedback; in phase 2, residents were randomized to receive traditional feedback (control group) or traditional feedback with performance metric reports (intervention group); and in phase 3, all residents received monthly performance metric reports and traditional feedback. To assess resident satisfaction with the feedback process, surveys using 6-point Likert scales were administered at each study phase and analyzed using two-sample t-tests. Analysis of variance in repeated measures was performed to compare impact of feedback on resident clinical performance, specifically patient treatment time (PTT) and patient visits per hour. Results Forty-one residents participated in the trial of which 21 were randomized to the intervention group and 20 in the control group. Ninety percent of residents liked receiving the report and 74% believed that it better prepared them for expectations of becoming an attending physician. Additionally, residents randomized to the intervention group reported higher satisfaction (p = 0.01) with the quality of the feedback compared to residents in the control group. However, receiving performance metric reports, regardless of study phase or postgraduate year status, did not affect clinical performance, specifically PTT (183 minutes vs. 177 minutes, p = 0.34) or patients visits per hour (0.99 vs. 1.04, p = 0.46). Conclusions While feedback with performance metric reports did not improve resident clinical performance, resident physicians were more satisfied with the feedback process, and a majority of residents expressed liking the reports and felt that it better prepared them to become attending physicians. Residency training programs could consider augmenting feedback with performance metric reports to aide in the transition from resident to attending physician.
Synergy between AUUUA motif disruption and enhancer insertion results in autocrine transformation of interleukin-3-dependent hematopoietic cells

Previously, we characterized the transposition of an intracisternal type A particle (IAP) to the 32 untranslated region (UTR) of the interleukin-3 (IL-3) gene, which displaced two of the six AUUUA motifs associated with mRNA stability in an IL-3-secreting clone. To determine whether this rearrangement was involved in the autocrine transformation of the parental IL-3-dependent FL5.12 cell line, the germline (gIL-3) and rearranged IL-3 (rIL-3) genes were isolated and subcloned into a gene transfer vector. Moreover, the IAP-long terminal repeat (LTR) and the IL-3 32 UTR AUUUA motifs were deleted (rIL-3 + delta LTR and gIL-3 + delta AUUUA) in some IL-3 constructs to ascertain their role in the transformation process. The IAP-LTR was also added to these constructs (rIL-3 + delta LTR + IAP-LTR, gIL-3 + delta AUUUA + IAP-LTR, and gIL-3 + IAP-LTR), to determine whether it was necessary for autocrine transformation. The ability of the modified IL-3 genes to abrogate the IL-3 dependency of FL5.12 cells had the following rank order: rIL-3 was greater than rIL-3 + delta LTR + IAP-LTR, which was greater than gIL-3 + delta AUUUA + IAP-LTR, which was greater than gIL-3 + delta AUUUA, which was equal to rIL-3 + delta LTR, which was greater than gIL-3. The half-life of IL-3 mRNA was 20-fold longer in cells containing a mutated as opposed to a wild-type AUUUA region. All of the factor-independent cells that expressed the IL-3 transgenes secreted IL-3 and were tumorigenic after injection into BALB/c nude mice. These results indicated that two events could synergize in the autocrine transformation of hematopoietic cells: (1) addition of a transcriptional enhancer present in a retroviral LTR, and (2) disruption of an mRNA stability region.
The brain and eye: Treating cerebral and retinal ischemia through mitochondrial transfer.

Stroke remains a devastating disease with limited treatment options, despite our growing understanding of its pathology. While ischemic stroke is traditionally characterized by a blockage of blood ...
Examining the Correlation Between Altmetric Score and Citations in the General Surgery Literature.

Abstract Background With the emergence of social media platforms, new bibliometric profiles measuring impact and exposure of scientific research online have been introduced as an alternative to traditional bibliometric outcomes. The objective of this article is to evaluate relationships between Altmetric scores, journal impact factor, and citation counts among the surgical literature. Methods We analyzed the top 10 highest cited articles for the 10 general surgery journals with the highest impact factors for 2013 and 2016 by noting citation counts and Altmetric scores for each article. We also identified the journal impact factor and age of journal associated Twitter accounts. Variables were assessed for correlation using Pearson’s correlation testing via Microsoft Excel. Results A total of 240 articles were analyzed. For 2013, Altmetrics score analysis demonstrated a significant, positive correlation with citation number (r = 0.462, P Conclusions Altmetric scores, while significantly associated with citation count in the surgical literature, should not necessarily be used as a surrogate marker for evaluating research performance, impact, or exposure. It is possible, however, that as the use of social media for distributing and sharing scientific research continues to expand, that exposure on such platforms could impact future interest or studies.
Tree Inference: Response Time in a Binary Multinomial Processing Tree, Representation and Uniqueness of Parameters

A Multinomial Processing Tree (MPT) is a directed tree with a probability associated with each arc. Here we consider an additional parameter associated with each arc, a measure such as the time required to select the arc. MPTs are often used as models of tasks. Each vertex represents a process and an arc descending from a vertex represents selection of an outcome of the process. A source vertex represents processing that begins when a stimulus is presented and a terminal vertex represents making a response. Responses are partitioned into classes. An experimental factor selectively influences a vertex if changing the level of the factor changes parameter values on arcs descending from that vertex and on no others. Earlier work shows that if each of two experimental factors selectively influences a different vertex in an arbitrary MPT it is equivalent for the factors to one of two relatively simple MPTs. Which of the two applies depends on whether the two selectively influenced vertices are ordered by the factors or not. A special case, the Standard Binary Tree for Ordered Processes, arises if the vertices are so ordered and the factor selectively influencing the first vertex changes parameter values on only two arcs descending from that vertex. Here we derive necessary and sufficient conditions for the probability and measure associated with a particular response class to be accounted for by this special case. Parameter values are not unique and we give admissible transformations for transforming one set of parameter values to another. When an experiment with two factors is conducted, the number of observations and parameters to be estimated depend on the number of levels of each factor; we provide degrees of freedom.
Genetic control of the human brain proteome

We generated an online brain pQTL resource for 7,376 proteins through the analysis of genetic and proteomic data derived from post-mortem samples of the dorsolateral prefrontal cortex of 330 older adults. The identified pQTLs tend to be non-synonymous variation, are over-represented among variants associated with brain diseases, and replicate well (77%) in an independent brain dataset. Comparison to a large study of brain eQTLs revealed that about 75% of pQTLs are also eQTLs. In contrast, about 40% of eQTLs were identified as pQTLs. These results are consistent with lower pQTL mapping power and greater evolutionary constraint on protein abundance. The latter is additionally supported by observations of pQTLs with large effects' tending to be rare, deleterious, and associated with proteins that have evidence for fewer protein-protein interactions. Mediation analyses using matched transcriptomic and proteomic data provided additional evidence that pQTL effects are often, but not always, mediated by mRNA. Specifically, we identified roughly 1.6 times more mRNA-mediated pQTLs than mRNA-independent pQTLs (550 versus 341). Our pQTL resource provides insight into the functional consequences of genetic variation in the human brain and a basis for novel investigations of genetics and disease.
Bone Cement Internal Auditory Canal Reconstruction to Reduce CSF Leak After Vestibular Schwannoma Retrosigmoid Approach.

OBJECTIVE To describe rates of cerebrospinal fluid (CSF) rhinorrhea after reconstruction of the IAC with calcium phosphate bone cement during retrosigmoid resections of vestibular schwannomas. METHODS A retrospective chart review of 177 patients who underwent retrosigmoid craniotomy and opening of the internal auditory canal for resection of a vestibular schwannoma between January 2016 and September 2019 at a tertiary referral center. Patients with other cerebellopontine angle tumor histology, neurofibromatosis type II, or those undergoing revision surgeries were excluded. RESULTS Out of 177 patients, six patients (3.4%) developed postoperative rhinorrhea. Four patients (2.3%) were taken back to the OR for mastoidectomy and repair of CSF leak. Three of these patients were noted to have a CSF leak from the peri-labyrinthine air cells, and one was found to have a leak from the craniotomy site communicating with the mastoid air cells. Two patients were conservatively managed with diuretics and had resolution of their CSF leak. Six patients (3.4%) were readmitted for postoperative infection. Two patients were diagnosed with meningitis (1.1%), one aseptic and one H. Influenza, and three patients developed surgical site infections (1.6%). One patient was empirically treated with antibiotics and ultimately had a negative CSF culture. CONCLUSIONS Our results demonstrate that the use of calcium phosphate bone cement for IAC closure in retrosigmoid resection of vestibular schwannomas is a safe and effective technique with low rates of postoperative CSF rhinorrhea.
The Virtual Residency Interview Season: Are You Ready? Here We Go Again!

The article focuses on residency application and interview season began in unprecedented times, with the COVID-19 in full swing and in the midst of a crucial movement to systemic racism plaguing our country, applicants and programs were compelled to set aside the abundant stress and trauma of the times. Topics include the reality of virtual interviewing was upon us and the Council on Resident Education in Obstetrics and Gynecology has released recommended standards for the 2021–22 match season.
Risk Factors for Aseptic Revision of Operatively Treated Ankle Fractures.

Background:Early revision rates within 12 months after ankle fracture open reduction internal fixation (AF-ORIF) are fairly low; however, they remain relevant given the volume of ankle fractures oc...
Kaposi Sarcoma: What to do with a negative HHV-8 immunohistochemical stain?

Kaposi sarcoma (KS) is an intermediate vascular sarcoma that can cause significant morbidity and mortality in patients if left untreated. It is associated with human herpes virus 8 (HHV-8) infection. Definitive diagnosis is supported by classic histology including slit-like vascular spaces, spindle cells, lymphocyte infiltration, and extravasated RBCs on hematoxylin and eosin (H&E) stain and positive immunohistochemical (IHC) staining for HHV-8. We present a challenge we encountered in detecting HHV-8 by IHC in a mucosal lesion demonstrating classic histology for KS. This article is protected by copyright. All rights reserved.
Tics and Tourette Syndrome

Tics are one of the most common behavioral problems of childhood; by some estimates, 12–24% of all children exhibit tics at one time or another (Shapiro, Shapiro, Brunn, & Sweet, 1978). Most tics are transient, disappearing spontaneously within a few weeks or months. Other tics are chronic and persist for years, even for life. Occasionally, motor tics are accompanied by “vocal” or “phonic” tics—sniffing, snorting, grunting, or swearing—to produce the condition called Tourette syndrome (Golden, 1979). Whether these tic conditions are different disorders or represent a continuum of the same disorder is unknown. What is known is that there is a relatively high incidence of tic disorders in the families of children who present with these problems. In an early study, Lapouse and Monk (1964) reported that 38% of parents of children with transient tics had a history of tics themselves; more recently, Golden (1979) indicated that 31% of the families of Tourette children had another member with Tourette syndrome, while 20% of the families had at least one other member of the family with chronic multiple tics. Similarly, Shapiro and Shapiro (1982) reported the rate of tics and Tourette syndrome to be 40.5% in the families of their sample of 650 Tourette children. Clearly, these familial rates exceed prevalence rates found in the general population, which are usually estimated to be 0.5 per 1,000 for Tourette syndrome and 1 per 100 for chronic multiple tics.
Financial Well-Being of Older Divorced/Separated Men and Women: Findings from a Panel Study.

Longitudinal data obtained from interviews were used to compare the objective and subjective financial well-being of older, divorced/separated men (n = 114) and women (n = 251) at the beginning and end of a ten year period. Men and women did not differ in satisfaction with their level of living or assessments of financial adequacy by men were more likely to be negative over the decade than those women. Models explaining satisfaction with level of living were fairly comparable for men and women except for the importance of change in health among women.
Methane exchange between marshland and the atmosphere over China during 1949-2008

[1] We used a process-based ecosystem model to examine methane (CH4) fluxes in the marshland across China as a result of multifactor global changes during 1949–2008. Our simulated results show a significant declining rate of 18.7 Gg Ca−1 (1Gg = 109 g) (with a 95% confidence boundary of 17.6 ∼ 19.8 Gg C a−1) at national scale, but substantially varying from the maximum annual CH4 emission of 2.4 Tg C a−1 (1Tg = 1012 g) (with a 95% confident boundary of 1.8 ∼ 3.4 Tg C a−1) in 1952 to the minimum annual CH4 emission of 1.3 Tg C a−1 (with a 95% confident boundary of 1.0 ∼ 1.9 Tg C a−1) in 2003. The marshland loss made the largest contribution to the CH4 emission reduction with an cumulative effect of 37.9 Tg C (with a 95% confident boundary of 28.0 ∼ 54.1 Tg C) for the past 60 years. Ozone pollution reduced CH4 emission, while elevated atmospheric CO2, nitrogen deposition, climate change, and multiple-factor interaction, cumulatively stimulated CH4emission. Climate variability predominately controlled the inter-annual variations in CH4 emissions. A substantial spatial variation in CH4 emission was observed across China's marshland. At regional scale, the Northeast, followed by Northwest and Southeast, made the greatest contribution, while North and Southwest made minor contributions to the national CH4 emission. This study suggests that it is necessary to consider multiple global change factors when estimating regional CH4 fluxes in natural wetlands.
Accelerated partial breast irradiation: the case for current use

The treatment of early stage breast cancer is evolving from traditional breast conservation techniques, employing conventionally fractionated whole breast irradiation, to techniques in which partial breast irradiation is used in an accelerated fractionation scheme. A growing body of evidence exists, including favorable findings. Additional studies are under way that may ultimately prove equivalence. The logic behind this approach is reviewed, and the currently available data are presented to support the current use of carefully applied partial breast irradiation techniques in appropriately selected and informed patients.
Why there is no impossibility theorem on Secure Quantum Bit Commitment

The impossibility proof on unconditionally secure quantum bit commitment is critically reviewed. Different ways of obtaining secure protocols are indicated.
A stable 250 to 4000 MHz GaAs IQ modulator IC

An in-phase/quadrature (IQ) vector modulator provides the capability to simultaneously modulate the magnitude and phase of a carrier. This versatile modulation capability is widely used in communications systems to generate signals of minimal spectral width. An accurate and broadband IQ modulator is a valuable part of a general-purpose test-signal generator. This 250 to 4000MHz GaAs FET IQ modulator IC uses an RC and a CR network to create quadrature signals.
Radiative lifetimes and transition probabilities for electric-dipole delta n equals zero transitions in highly stripped sulfur ions

The beam-foil time-of-flight method has been used to investigate radiative lifetimes and transition rates involving allowed intrashell transitions within the L shell of highly ionized sulfur. The results for these transitions, which can be particularly correlation-sensitive, are compared with current calculations based upon multiconfigurational models.