cssi/SciSciGPT-SciSciNet huggingface dataset:
Pain management misstatements: ceiling effects, red and yellow flags.

Dr. Howard Heit does an excellent and accurate job in his piece, expressing the hope and disappointment many of us felt in advance of and following our opportunity to speak with the Drug Enforcement Administration (DEA) about the interim policy statement (IPS). I was also “in attendance” that day, but due to other commitments participated via telephone. I listened intently until it was my turn. Those who went before me described the negative effects of both aspects of the IPS and the pulling of Prescription Pain Medications: Frequently Asked Questions and Answers (FAQ) (of which I was one of the authors). It was hard to judge the mood in the room. The DEA representatives were in listening mode, so without seeing them, I could not easily tell how the reasoned arguments and statements being made (not just by those who prescribe controlled substances, but also by those who have seen the negative impact of the IPS on pharmacy and nursing practice) were being received. I was hoping for the best. The FAQ was meant not as a policy statement but as a document to help DEA agents better understand the way pain medicine is practiced. It …
Problem-Solving in Relation to Abuse by a Partner

The present study investigated the usefulness of the construct of abuse-related problem-solving in relation to the reported experience of abuse by a partner in both clinical and nonclinical samples of women. Data were collected from a clinical sample of 101 women who were receiving treatment at a domestic violence shelter and from a nonclinical sample of 635 female undergraduates attending a medium-sized university. Analysis indicated that women in both samples who possessed good abuse-related problem-solving ability reported experiencing less abuse from their partners. The usefulness of this construct as well as its limitations were noted.
Treating HIV during pregnancy: an update on safety issues.

The expanded use of multiple antiretroviral drugs during pregnancy has led to a reduction in the occurrence of perinatal transmission of HIV to 250 cells/μL at treatment initiation and among pregnant women on long-term didanosine and stavudine. These drugs should be avoided in such situations if alternatives are available. Efavirenz has been associated with birth defects in monkeys, and several cases of neural tube defects have been reported in humans after first trimester exposure, so treatment with this drug should be avoided during the first trimester. Protease inhibitors have been associated with an increased risk of maternal glucose intolerance, pre-eclampsia and preterm birth in some, but not all, studies. Pregnancies exposed to antiretroviral therapy should be registered with the Antiretroviral Pregnancy Registry as early in pregnancy as possible in order to provide data on the risk of birth defects after exposure. The pharmacokinetics of nucleoside and non-nucleoside reverse transcriptase inhibitors are not significantly changed in pregnancy, so standard dosing may be used. However, concentrations of several protease inhibitors are lower in pregnancy, so ritonavir-boosting or increased doses are required. Of great theoretical concern is the impact of resistance mutations that develop following single-dose nevirapine therapy on the response to later therapy among women and their infected infants. The use of dual nucleoside therapy for 3–7 days after single-dose nevirapine in the mother reduces but does not eliminate the risk of nevirapine resistance; alternative regimens for prevention of resistance are under study, as are the subsequent responses of the mother and her infant to therapy. Short courses of prophylactic zidovudine and nevirapine have been well tolerated in neonates. Concern has been raised, however, that these exposures may lead to persistent mitochondrial dysfunction or later cancers, underscoring the need for long-term surveillance of antiretroviral-exposed, HIV-uninfected infants.
Kinetics of Leaching of Lead Glass by Ethylenediaminetetraacetic Acid

Treatment of lead glass with a hot basic solution of the sodium salt of ethylenediaminetetraacetic acid (EDTA) was shown to remove lead from the glass surface. A mechanism is proposed whereby lead is removed by a two-step reaction involving hydroxyl ions and EDTA. The rate constant and the overall heat of activation were estimated for this reaction. Potassium and silicon are also removed from the glass surface and show a dependence similar to that of lead removal. Potassium and silicon, however, do not form complexes with EDTA. Thus, it appears that lead removal weakens the silicate structure of the glass surface, allowing the potassium and silicon to be attacked and removed by hydroxyl ions and/or water. Experimental results indicate that the silicon released from the glass surface is in the form of silica.
HK97 maturation studied by crystallography and H/2H exchange reveals the structural basis for exothermic particle transitions.

HK97 is an exceptionally amenable system for characterizing major conformational changes associated with capsid maturation in double-stranded DNA bacteriophage. HK97 undergoes a capsid expansion of {approx}20%, accompanied by major subunit rearrangements during genome packaging. A previous 3.44-{angstrom}-resolution crystal structure of the mature capsid Head II and cryo-electron microscopy studies of other intermediate expansion forms of HK97 suggested that, primarily, rigid-body movements facilitated the maturation process. We recently reported a 3.65-{angstrom}-resolution structure of the preexpanded particle form Prohead II (P-II) and found that the capsid subunits undergo significant refolding and twisting of the tertiary structure to accommodate expansion. The P-II study focused on major twisting motions in the P-domain and on refolding of the spine helix during the transition. Here we extend the crystallographic comparison between P-II and Head II, characterizing the refolding events occurring in each of the four major domains of the capsid subunit and their effect on quaternary structure stabilization. In addition, hydrogen/deuterium exchange, coupled to mass spectrometry, was used to characterize the structural dynamics of three distinct capsid intermediates: P-II, Expansion Intermediate, and the nearly mature Head I. Differences in the solvent accessibilities of the seven quasi-equivalent capsid subunits, attributed to differences in secondary and quaternary structures,more » were observed in P-II. Nearly all differences in solvent accessibility among subunits disappear after the first transition to Expansion Intermediate. We show that most of the refolding is coupled to this transformation, an event associated with the transition from asymmetric to symmetric hexamers.« less
Occupational Meanings and Spirituality: The Quest for Sobriety

This article compares two differing models of intervention for persons with alcohol dependence--the Moyers Model for occupational therapy and Alcoholics Anonymous (AA). Both models were found to share practice strategies but to differ in their emphasis on spirituality and self-control. Additionally, the Moyers Model was basically procedural in its description of the clinical reasoning process, whereas AA places great emphasis on the spiritual aspects of recovery. Because this disparity may lead to confusion when the person with alcohol dependence is involved in both an occupational therapy program (using Moyers Model) and an AA program, the Moyers Model was revised to include a conditional reasoning structure (i.e., a process for therapists to help clients find meaning in actions). By providing opportunities to explore meaning through action during occupations, the revised Moyers Model is both more consistent with the AA principles of spiritual recovery and in keeping with the occupational therapy philosophy of addressing the needs of the whole person.
Sound Localization by Barn Owls in a Simulated Echoic Environment

We examined the accuracy and precision with which the barn owl (Tyto alba) turns its head toward sound sources under conditions that evoke the precedence effect (PE) in humans. Stimuli consisted of...
Sequencing and characterization of a cDNA encoding a ferritin subunit of Colorado potato beetle, Leptinotarsa decemlineata.

A differentially expressed cDNA fragment (P311) from Colorado potato beetle (CPB), Leptinotarsa decemlineata (Say), was identified by restriction fragment differential display–polymerase chain reaction (RFDD-PCR) technique, and showed a strong similarity to ferritin heavy chain subunits of other organisms. Based on P311, we constructed specific primers and obtained a 840-bp cDNA fragment spanning the open reading frame of CPB ferritin subunit using the rapid amplification of cDNA ends (RACE) technique. The sequence encodes 213 amino acid residues, including a 19 amino acid signal peptide. The sequence has a conserved cysteine in the N-terminus and has the seven conserved residues that comprise the ferroxidase center, which is the feature of heavy chain ferritins of vertebrates. The CPB ferritin subunit has high amino acid sequence identity with the Apriona germari (69.3%), Galleria mellonela (54.5%), Manduca sexta (54.0%), Drosophila melanogaster (53.2%), Calpodes ethlius (51.4%), and Nilaparvata lugens (47.6%) but lower identity with the Anopheles gambiae (38.7%) and Aedes aegypti (37.8%). Using Northern blot analysis, the subunit mRNA was identified from fat body and midgut of 4th instars with much higher mRNA levels found in midgut than that in fat body (˜2.5-fold). Nevertheless, only the levels of mRNA in fat body was induced by dexamethasone (˜1.5-fold). Arch. Insect Biochem. Physiol. 60:140–150, 2005. © 2005 Wiley-Liss, Inc.
Synthesis of fluorine-18 labeled 1,1-difluoro-2,2-dichloroethyl aryl ethers by 18F-for-19F exchange

SUMMARY Fluorine-18 labeled l,l-difluoro-2,2-dichloroethyl aryl ethers have been prepared by a facile 18F-for-19F isotopic exchange reaction. The isotopic exchange proceeds in good to excellent yields (up to 85%), and is dependent on reaction time, temperature, and concentration of reactants (aryl ether or fluoride ion). Substitution even occurs at room temperature in DMSO, and at elevated temperature (100 to 155 OC) in DMSO or acetonitrile containing up to 20% water. Specific activities of 0.5-55 Ci/mol have been achieved, with the products obtained in pure radiochemical and chemical form.
Cyst Gastrostomy and Necrosectomy for the Management of Sterile Walled-Off Pancreatic Necrosis: a Comparison of Minimally Invasive Surgical and Endoscopic Outcomes at a High-Volume Pancreatic Center

Walled-off pancreatic necrosis (WON) is a sequela of acute necrotizing pancreatitis in 15–40 % of cases. We sought to compare the outcomes of minimally invasive surgical and endoscopic cyst gastrostomy (CG) and necrosectomy for the management for sterile WON at a tertiary care high-volume pancreas center. This is a retrospective review of patients who underwent minimally invasive surgical or endoscopic CG and necrosectomy for clinically sterile WON between 2008 and 2013. Peri-procedural outcomes including costs were analyzed and compared. Twenty patients underwent minimally invasive surgical (robotic = 14, laparoscopic = 6) CG and necrosectomy, and 20 patients underwent endoscopic treatment. The surgical cohort had a larger median cyst size and higher CCI score. For the surgical cohort, median OR time was 167.5 min, estimated blood loss was 30 ml, and 65 % underwent concomitant cholecystectomy. There was no mortality in either group and no difference in complication rates (20 %). The failure rate was similar (15 versus 10 %, P = 0.66). Although surgery was associated with a lower re-intervention rate (0 versus 1, P = 0.008), the endotherapy group was associated with shorter total LOS (inclusive of re-interventions) (7 versus 3 days, P = 0.032). The cost of the index procedure was significantly higher for the surgery group (P = 0.014); however, when considering all readmissions and re-interventions until resolution of the WON, the total cost was similar for both groups. Minimally invasive surgical and endoscopic CG and necrosectomy are comparable treatments for sterile WON in terms of outcomes and overall cost. The surgical approach may be considered advantageous when a concomitant cholecystectomy is required.
Anesthesia for carotid stent procedures.

Purpose:To present the techniques of anesthesia management used during percutaneous carotid interventions involving balloon dilation and stent deployment.Methods and Results:Two access routes may b...
A QUANTITATIVE THEORY OF THE PRECIPITIN REACTION : IV. THE REACTION OF PNEUMOCOCCUS SPECIFIC POLYSACCHARIDES WITH HOMOLOGOUS RABBIT ANTISERA.

1. The reaction between the specific polysaccharide of Type III pneumococcus and homologous antibody in rabbit sera is quantitatively accounted for by expressions similar to those derived from the mass law for the corresponding horse sera. Preliminary data are also given for the Type I reaction. 2. Differences and similarities of the reaction with antibodies produced by the two animals are discussed. 3. Calculations are made of the equivalent composition of the specific precipitate at various reference points in the reaction range. 4. Certain theoretical and practical implications of the findings are pointed out.
Effects of Multiple Acceptance and Rejection on Adults’ Psychological Adjustment: A Pancultural Study

The purpose of this study was to examine the effects on adults’ current psychological adjustment of perceived acceptance or rejection by mothers and fathers in childhood and by intimate partners in adulthood. The sample consisted of 1,709 adults (35 % male and 65 % female), including 1,645 individuals in the multiple acceptance group and 64 in the multiple rejection group. Respondents were selected from a total sample of 2,236 adults in 10 countries including Bangladesh, Colombia, Finland, India, Japan, Korea, Kuwait, Puerto-Rico, Turkey, and the USA. Measures used were the Intimate Partner Acceptance–Rejection/Control Questionnaire (IPAR/CQ), the Adult version of the Parental Acceptance–Rejection/Control Questionnaire for Mothers and Fathers (Adult PARQ/Control: Mothers and Fathers), and the Adult version of the Personality Assessment Questionnaire (Adult PAQ). Results showed that significantly more women than men experienced multiple acceptance, and significantly more men than women reported multiple rejection. Regardless of gender, the majority of respondents in the multiple acceptance group reported healthy psychological adjustment, whereas the majority of respondents in the multiple rejection group reported severe maladjustment.
Visible and near infrared reflectance characteristics of dry plant materials

Abstract Laboratory reflectance spectra of dry plant materials are distinctly different from green plant materials. The dry plant materials have diagnostic ligno-cellulose absorption features at 2·09 and in the 2·3μm region. The visible portion of spectrum is dominated by an absorption wing produced by intense blue and UV absorption. This absorption wing breaks down as plant decay progresses.
ADAPTIVE CORRECTIVE CONTROL STRATEGIES FOR PREVENTING POWER SYSTEM BLACKOUTS

In order to investigate power system security and design appropriate control strategies, power systems can be conceptually classified into five operational states: Normal, Alert, Emergency, In Extremis, and Restorative. Various preventive and corrective control strategies have been studied to cope with power systems in the different operational states. Our approach primarily focuses on the corrective control strategies for power systems under emergency and in extremis states. In this paper, two cor- rective control approaches (transmission system reconfigu- ration and controlled system islanding) have been investi- gated and new algorithms have been developed. When the system is in the emergency state, two reconfiguration strategies, line switching and bus-bar switching, have been presented to solve the problems of overloads or voltage violations. Furthermore, to prevent a total system black out, a slow coher-ency grouping based adaptive power system islanding approach using minimal cutsets has been presented to deal with catastrophic events when power system vulnerability analysis indicates that the system is approaching the in extremis state. A controlled under frequency load shedding scheme with the rate of frequency decline is also proposed to balance the real power within each island and aid restoration. The verification of our approach is proven with simulations on a 179-bus, 29- generator WECC system.
Enumeration with Constraints: A Possible Approach to Protein Structure Reconstruction from NMR Data

We suggest a new algorithm which enumerates all and only all conformations of a protein which satisfy a given set of constraints presented as a set of known interatomic contacts. The algorithm is very effective and allowed to investigate the dependence of number of protein conformations on the number of constraints. This dependence is very dramatic so that introduction of few constraints decrease the number of conformations significantly making their enumeration and analysis feasible. The record calculation yielded 2134672156 conformations of Crambin on diamond lattice when only 6 interatomic contacts (3 originating from S-S bonds and three other) were given. These results suggest a new approach to determination of protein conformations using very limited NMR data about contacts in the native state.
Proximity drawings of outerplanar graphs (extended abstract)

A proximity drawing of a graph is one in which pairs of adjacent vertices are drawn relatively close together according to some proximity measure while pairs of non-adjacent vertices are drawn relatively far apart. The fundamental question concerning proximity drawability is: Given a graph G and a definition of proximity, is it possible to construct a proximity drawing of G? We consider this question for outerplanar graphs with respect to an infinite family of proximity drawings called β-drawings. These drawings include as special cases the well-known Gabriel drawings (when β=1), and relative neighborhood drawings (when β=2). We first show that all biconnected outerplanar graphs are β-drawable for all values of β such that 1 ≤ β ≤ 2. As a side effect, this result settles in the affirmative a conjecture by Lubiw and Sleumer [15, 17], that any biconnected outerplanar graph admits a Gabriel drawing. We then show that there exist biconnected outerplanar graphs that do not admit any convex β-drawing for 1 ≤ β ≤ 2. We also provide upper bounds on the maximum number of biconnected components sharing the same cut-vertex in a β-drawable connected outerplanar graph. This last result is generalized to arbitrary connected planar graphs and is the first non-trivial characterization of connected β-drawable graphs. Finally, a weaker definition of proximity drawings is applied and we show that all connected outerplanar graphs are drawable under this definition.
Water Sensitivity in Zn4O-Based MOFs is Structure and History Dependent

Moisture can cause irreversible structural collapse in metal-organic frameworks (MOFs) resulting in decreased internal surface areas and pore volumes. The details of such structural collapse with regard to pore size evolution during degradation are currently unknown due to a lack of suitable in situ probes of porosity. Here we acquire MOF porosity data under dynamic conditions by incorporating a flow-through system in tandem with positronium annihilation lifetime spectroscopy (PALS). From the decrease in porosity, we have observed an induction period for water degradation of some Zn4O-based MOFs that signals much greater stability than commonly believed to be possible. The sigmoidal trend in the degradation curve of unfunctionalized MOFs caused by water vapor has been established from the temporal component of pore size evolution as characterized by in situ PALS. IRMOF-3 is found to degrade at a lower relative humidity than MOF-5, a likely consequence of the amine groups in the structure, although, in con...
A thermodynamic comparison of external and internal exhaust gas dilution for high-efficiency internal combustion engines

The use of exhaust gases for creating dilute mixtures for internal combustion engines has been shown to play an important role for the development of high-efficiency engines. These exhaust gases ma...
Middle Eastern Terrorist Stereotypes and Anti-Terror Policy Support The Effect of Perceived Minority Threat

Tests of the minority threat theoretical perspective have established that the common association made between crime and Black and Hispanic males is manifested, to some degree, in harsh approaches to crime control. Particularly since 9/11, a close association is also being made by the public between terrorism and those perceived to be of Arab or Muslim descent—a phenomenon coinciding with the implementation of intense social controls aimed at preventing terror attacks and punishing suspected terrorists. Using a national sample, this research is the first to explore the micro-level minority threat hypothesis in relation to those who are perceived to be Middle Easterners. Results of multivariate analyses indicate that those who typify terrorists as Middle Eastern are more likely to support punitive anti-terror techniques and that this relationship is more influential among those for whom the danger of terrorism is less salient. These findings not only suggest that the effects of minority threat extend beyon...
A New Method for Accurate Identification and Evaluation of Cold Tolerance of Rice at Bud Stage

The cold tolerance of rice at bud stage is an important factor that affects the growth and development of rice buds,and it is one of the important traits of rice that can not be ignored in rice production. In this experiment,we focused on the defects of old methods for the identification and evaluation of cold tolerance of rice at bud stage,designed a new method for these,and tested the accuracy of these two methods by using 23 different genotypes of early rice varieties. The results of the experiment indicated that: by increasing the size of experimental samples and improving the standard of evaluation,this new method showed a comparatively higher accuracy; furthermore,because of using continuous numerical values to mark cold tolerance,the new method could make it feasible to compare cold tolerance between two rice genotypes,avoiding dividing large number of genotypes into a large group. The new method is sure to provide higher accuracy and selectivity in the large-scale identification and evaluation of cold tolerance of rice germplasm resources at bud stage.
A message on the occasion of the 50th anniversary of the World Health Organization

The Director of the Panamerican Health Organization gives us a message about the 50th anniversary of WHO, emphasizing its origin and characteristics, the successes of its programmes and policies to the sound management of health programmes in its member countries, through the strategy of primary health care and health for all programmes.
Quantifying rates of random mating in western corn rootworm emerging from Cry3Bb1‐expressing and refuge maize in field cages

The western corn rootworm (WCR), Diabrotica virgifera virgifera LeConte (Coleoptera: Chrysomelidae), is the most significant pest of field maize, Zea mays L. (Poaceae), in the USA. Maize plants expressing Bt toxins targeting the corn rootworm complex have been widely adopted and are the primary insecticidal control measure for this pest in North America. Insect resistance management tactics using various refuge structures have been adopted to ensure Bt products will retain durability. An assumption of the refuge strategy is that males and females emerging from Bt and refuge plantings mate randomly; this has not been tested in the field. We conducted cage studies using field populations of WCR in Indiana, USA, to generate empirical field data on mating rates between beetles emerging from Cry3Bb1‐expressing Bt and refuge maize plants. Two refuge configurations were tested; all refuge plants were labeled using the stable isotope ¹⁵N. This mark persists in adult beetles after eclosion, allowing for collection and analysis of isotopic ratios of all beetles. Additional data collected included adult emergence rates, timing and sex ratios for each of the treatments, and head capsule size and dry weights of beetles collected. Treatment had a significant effect on dry weight; mean dry weight decreased in Bt‐only treatments. Fisher's exact test of proportions of mating pairs of refuge and Bt insects indicated that mating was not random in 20% strip refuges and 5% seed blend treatments. We found high percentages of beetles that fed on Bt‐expressing plants as larvae, suggesting that mating between resistant beetles may not be rare even if random mating did occur.
AXONAL TRANSPORT AND PERIPHERAL NERVE DISEASE IN MAN

The basal content and rate of accumulation of dopamine-β-hydroxylase and acetylcholinesterase activity against a ligature have been measured in biopsy samples of sural nerve from normal human volunteers and patients with various peripheral nerve diseases. Consistent reductions in the rate of accumulation of dopamine-β-hydroxylase activity have been noted in DEjerine-Sottas disease, peroneal muscular atrophy, and hereditary sensory neuropathy type II. Because of the relatively normal basal levels of enzyme activity in these conditions, it seems likely that the transport of proteins is impaired, over and above any changes that may have occurred in the number of surviving axons and the rate of enzyme synthesis in the cell bodies giving rise to them.
Violence in Schools: Repeat Victimization, Low Self-Control, and the Mitigating Influence of School Efficacy

Examine the distribution of various forms of violent victimization among adolescents in school and the main and interactive effects of low self-control and school efficacy on repeat assault victimization. This study used data collected from students and teachers as part of the Rural Substance abuse and Violence Project. We calculated a simple Poisson model of the expected frequencies of adolescents to experience each number of assault, robbery, and weapons victimizations given the total number of each type of victimization reported by the sample. We then tested whether the observed frequencies differed significantly from the expected. Finally, we estimated a series of hierarchical nonlinear models to assess the main and interactive effects of low self-control and school efficacy on repeat assault victimization. All three forms of violent victimization were non-randomly distributed across students. Low self-control was associated with repeat victimization among assault victims, though this effect was weakened significantly by school efficacy. Violence in schools is highly concentrated among repeat victims. Efforts to reduce violence in schools should be focused on those who have already been victimized. Schools may be able to limit the effects of low self-control on repeat assault victimization by strengthening school efficacy.
Evidence-based treatment and supervision practices for co-occurring mental and substance use disorders in the criminal justice system.

Background: Over seven million persons in the United States are supervised by the criminal justice system, including many who have co-occurring mental and substance use disorders (CODs). This popul...
DATABASE REPRESENTATIONS IN HIERARCHICAL SCENE ANALYSIS

Publisher Summary This chapter presents database representations in hierarchical scene analysis. Digital scene analysis may be defined as the process of using a digital computer to extract, characterize, and interpret information from images of a three-dimensional world. Interest in scene analysis methods ranges from biomedical to industrial and military applications. Regardless of specific application, however, an essential characteristic of digital scene analysis techniques is the use of a machine for performing intelligent tasks, where the standard for intelligent behavior on the part of the machine is established by the capability of a human in performing the same tasks. The importance of scene analysis techniques in the broader field of machine intelligence can be easily grasped by a cursory review of the application areas in this field based on pictorial information. One of the principal characteristics of scene analysis, in fact, of machine intelligence in general, is the use of heuristics. There is no general theory for selecting the measurements, features, recognition, and interpretation techniques needed for the implementation of scene analysis systems.
The Use of Magnetic Resonance Imaging to Predict Oncological Control Among Candidates for Focal Ablation of Prostate Cancer.

OBJECTIVE To provide insights into the role of multiparametric magnetic resonance imaging (mpMRI) in predicting oncological control following 2 focal ablation (FA) templates for selective cases of prostate cancer. MATERIALS AND METHODS A total of 59 radical prostatectomies were performed between 2012 and 2016 on cases that fulfilled criteria for FA. The Gleason score (GS), extent of Gleason pattern (GP) 4, maximum linear cross-sectional length (MLCSL), and location of tumor foci were recorded and related to scale on corresponding 3-mm transverse slice prostate maps. Gleason pattern 4 extra-focal disease (GP4EFD) was defined as prostate cancer with any GP 4 not detected by mpMRI and transrectal ultrasound systematic biopsy observed outside a specified ablation zone. The location of these GP4EFD relative to the MRI lesion (MRI-L) (contralateral or ipsilateral) was recorded and used to predict oncological control following a hypothetical margin and ipsilateral hemi-ablation templates. RESULTS Overall, 15 of 59 (25.4%) of the prostate specimens had at least 1 GP4EFD. Of the total 20 GP4EFD, 7 of 20 (35%) were ipsilateral and 13 of 20 (65%) were contralateral to the MRI-L. Of the GP4EFD, 16 of 20 (80%), 2 of 20 (10%), and 2 of 20 (10%) were GS 3 + 4, GS 4 + 3, and GS 4 + 4, respectively. Of these GP4EFD, 10 of 20 (50%) exhibited an MLCSL <5 mm. Ablating only the MRI-L+10 mm or performing an ipsilateral hemi-ablation would leave residual GP4 in 14 of 59 (23.7%) and 11 of 59 (18.6%) of cases, respectively. CONCLUSION Because a significant proportion of candidates for FA based on mpMRI and systematic biopsy will have pre-existing GP4EFD outside ablation templates, active surveillance of the untreated prostate is mandatory.
High-Fidelity Emergency Department Thoracotomy Simulator With Beating-Heart Technology and OSATS Tool Improves Trainee Confidence and Distinguishes Level of Skill.

Objective Resuscitative Thoracotomy or Emergency Department Thoracotomy (EDT) is a time-sensitive and potentially life-saving procedure. Yet, trainee experience with this procedure is often limited in both clinical and simulation settings. We sought to develop a high-fidelity EDT simulation module and assessment tool to facilitate trainee education. Design Using the Kern model for curricular development, a group of expert trauma surgeons identified EDT as a high-stakes, low-frequency procedure. Task analysis identified 5 key steps of EDT: (1) opening chest/rib spreader utilization; (2) pericardiotomy/cardiac repair; (3) open cardiac massage; (4) clamping aorta; and (5) control of pulmonary hilum. A high-fidelity simulator with beating-heart technology was built. The previously validated Objective Structured Assessment of Technical Skills (OSATS) was adapted to create the “EDT-OSATS” which assessed performance along several domains: (1) Surgical technique (key steps); (2) general skills; and (3) global rating. A pilot test was performed to compare board-certified trauma surgeons (i.e., Experts) with categorical general surgery interns (i.e., Novices). Each subject received preparatory materials, completed a presimulation quiz, performed a videotaped procedure on the EDT simulator, and completed a postmodule survey. Two independent raters scored performances using the EDT-OSATS. Groups were compared in descriptive and unadjusted analyses. We hypothesized that our EDT simulation module would distinguish between expert vs novice performance and improve trainee confidence. Setting Simulation laboratory at Massachusetts General Hospital in Boston, MA. Participants Trauma surgeons (Experts, n = 6) and categorical general surgery interns (Novices, n = 8). Results Experts scored significantly higher than Novices on nearly all components of the EDT-OSATS, including: (1) surgical technique: pericardiotomy (4.2 vs 3.4, p = 0.040), cardiac massage (3.6 vs 2.4, p = 0.028), clamping aorta (4.1 vs 3.3, p = 0.035), control of pulmonary hilum (4.8 vs 3.4, p Conclusions Our novel high-fidelity beating-heart EDT simulator is realistic and improves trainee confidence in this low-frequency, high-stakes emergency procedure. The EDT-OSATS tool differentiates between performances of experienced surgeons vs novice trainees on the beating-heart simulator. This training module and accompanying assessment instrument hold promise as a learning tool for clinicians who may perform emergency department thoracotomy.
Membrane Reactor Equilibrium Conversion

The equilibrium constant of any reaction is function of temperature only. The equilibrium of a conventional/traditional reacting system is function only of the thermodynamic variables (temperature, pressure, and mixture composition). It is independent from the reactor model (continuous stirred tank reactor, plug flow reactor, batch reactor, etc.), fluid dynamics (mixing, diffusion, etc.), heat exchange (isothermal, adiabatic, or no-isothermal reactor), reactor size, etc. since the equilibrium is reached when variation in temperature, pressure, and composition is no longer present in the chemical system. This condition is mathematically expressed by the following equations set valid for a reacting closed (no mass transfer with the environment) system consisting of N reactions.
Mild fetal ventriculomegaly: diagnosis, evaluation, and management.

Ventriculomegaly is defined as dilation of the fetal cerebral ventricles and is a relatively common finding on prenatal ultrasound. The purpose of this document is to review the diagnosis, evaluation, and management of mild fetal ventriculomegaly. When enlargement of the lateral ventricles (≥10 mm) is identified, a thorough evaluation should be performed, including detailed sonographic evaluation of fetal anatomy, amniocentesis for karyotype and chromosomal microarray analysis, and a workup for fetal infection. In some cases, fetal magnetic resonance imaging may identify other central nervous system abnormalities and should be considered when this technology as well as expert interpretation is available. Follow-up ultrasound examination should be performed to assess for progression of the ventricular dilation. In the setting of isolated ventriculomegaly of 10-12 mm, the likelihood of survival with normal neurodevelopment is >90%. With moderate ventriculomegaly (13-15 mm), the likelihood of normal neurodevelopment is 75-93%. The following are Society for Maternal-Fetal Medicine recommendations: We suggest that ventriculomegaly be characterized as mild (10-12 mm), moderate (13-15 mm), or severe (>15 mm) for the purposes of patient counseling, given that the chance of an adverse outcome and potential for other abnormalities are higher when the ventricles measure 13-15 mm vs 10-12 mm (GRADE 2B); we recommend that diagnostic testing (amniocentesis) with chromosomal microarray analysis should be offered when ventriculomegaly is detected (GRADE 1B); we recommend testing for cytomegalovirus and toxoplasmosis when ventriculomegaly is detected, regardless of known exposure or symptoms (GRADE 1B); we suggest that magnetic resonance imaging be considered in cases of mild or moderate fetal ventriculomegaly when this modality and expert radiologic interpretation are available; magnetic resonance imaging is likely to be of less value if the patient has had a detailed ultrasound performed by an individual with specific experience and expertise in sonographic imaging of the fetal brain (GRADE 2B); we recommend that timing and mode of delivery be based on standard obstetric indications (GRADE 1C); we recommend that with isolated mild ventriculomegaly of 10-12 mm, after a complete evaluation, women be counseled that the outcome is favorable, and the infant is likely to be normal (GRADE 1B); we recommend that with isolated moderate ventriculomegaly of 13-15 mm, after a complete evaluation, women be counseled that the outcome is likely to be favorable but that there is an increased risk of neurodevelopmental disabilities (GRADE 1B).
Molecular Photoacoustic Contrast Agents: Design Principles & Applications

Photoacoustic imaging (PAI) is a rapidly growing field which offers high spatial resolution and high contrast for deep-tissue imaging in vivo. PAI is nonionizing and noninvasive and combines the optical resolution of fluorescence imaging with the spatial resolution of ultrasound imaging. In particular, the development of exogenous PA contrast agents has gained significant momentum of late with a vastly expanding complexity of dye materials under investigation ranging from small molecules to macromolecular proteins, polymeric and inorganic nanoparticles. The goal of this review is to survey the current state of the art in molecular photoacoustic contrast agents (MPACs) for applications in biomedical imaging. The fundamental design principles of MPACs are presented and a review of prior reports spanning from early-to-current literature is put forth.
The Training and Support of Health Care Professionals Dealing with the Psychiatric Aspects of AIDS

Over the past 8 years of the acquired immune deficiency syndrome (AIDS) epidemic, health care providers have been affected as definitively as patients. Many have reported feeling overwhelmed by their caseloads of young terminal patients or perhaps inspired by the courage and resourcefulness demonstrated by their patients in responding to the illness. Some have been appalled at the level of discrimination and social sanction endured by patients and their family members. Still others have personally experienced a level of ostracism or social isolation from colleagues, as a result of “AIDS phobia” and prevailing fear about the disease.
The Fornix System and Related Hippocampal Connections

One of the most prominent fiber systems of the forebrain is the fornix, which becomes obvious at the level of the anterior poles of the hippocampus. At this level, the total fornix bundle is actually composed of the fibers of the fimbria and the more medially located fibers of the dorsal fornix. From this point of convergence, the fibers arch downward (“fornix” means arch) and split into two components: a rather diffuse component that descends through the septum anterior to the level of the anterior commissure into the preoptic area and a more compact postcommissural component that descends to the mammillary bodies. The series of coronal and parasagittal sections in Figure 5-1 shows the general topography of this fiber bundle.
Community trend outlier detection using soft temporal pattern mining

Numerous applications, such as bank transactions, road traffic, and news feeds, generate temporal datasets, in which data evolves continuously. To understand the temporal behavior and characteristics of the dataset and its elements, we need effective tools that can capture evolution of the objects. In this paper, we propose a novel and important problem in evolution behavior discovery. Given a series of snapshots of a temporal dataset, each of which consists of evolving communities, our goal is to find objects which evolve in a dramatically different way compared with the other community members. We define such objects as community trend outliers. It is a challenging problem as evolutionary patterns are hidden deeply in noisy evolving datasets and thus it is difficult to distinguish anomalous objects from normal ones. We propose an effective two-step procedure to detect community trend outliers. We first model the normal evolutionary behavior of communities across time using soft patterns discovered from the dataset. In the second step, we propose effective measures to evaluate chances of an object deviating from the normal evolutionary patterns. Experimental results on both synthetic and real datasets show that the proposed approach is highly effective in discovering interesting community trend outliers.
Singularity analysis in quantum chemistry

Abstract The Schrodinger equation for an atom or molecule includes parameters, such as bond lengths or nuclear charges, and the resulting energy eigenvalue can be treated as a function with the parameter values as continuous variables. Analysis of singular points of this function, at nonphysical parameter values, can explain and predict the success or failure of quantum chemical calculation methods. An introduction to the theory of singularities in functions of a complex variable is presented and examples of applications to quantum chemistry are described, including the calculation of molecular potential energy curves, the theoretical description of ionization, and the summation of perturbation theories.
Assessment of Resisted Trunk Rotation Exercise With and Without Kiai Double-Pulse Breathing Technique on Hockey Shot Velocity: A Pilot Study.

Abstract Objective The purpose of this study was to assess the feasibility of a study to measure the effect of resisted band antirotation exercises with the use of a double-pulse (DP) breathing kiai exercise on slapshot and snap shot velocity and subjective assessment of performance. Methods Ten participants between 20 and 30 years of age who play ice hockey were recruited. The study was conducted over 3 weeks, and participants were randomized into 2 groups; group 1: resisted band antirotations with DP kiai (a shout used in martial arts) exercises, and group 2: resisted band antirotations alone. After week 1, there was a 1-week washout period, after which group 1 performed resisted band antirotations alone, and group 2 performed resisted band antirotations with DP kiai exercises. Results Data were successfully collected on all 10 participants. There appeared to be no difference between groups regarding slapshot and snap shot velocity. Conclusion The design for this study appears to be feasible. Preliminary data show that the average shot velocity before and after the intervention did not show a positive relationship between DP kiai breathing and hockey shot (slapshot and snap shot) velocity.
Perioperative Management of Total Laryngectomy Patients: A Survey of American Head and Neck Society Surgeons:

Objectives:Standards of care for total laryngectomy (TL) patients in the postoperative period have not been established. Perioperative care remains highly variable and perhaps primarily anecdotally...
Can geometric diodes improve performance of optical rectennas

Infrared rectennas often use metal-insulator-insulator-metal (MIIM) diodes since their femtosecond scale tunneling is fast enough to rectify terahertz signals. Many factors threaten to degrade the rectenna performance, such as impedance matching with the antenna and material losses at frequency, but the most challenging limitation is the diode’s rectification efficiency. Geometric diodes, planar conductors with a geometric asymmetry that imposes a preferred current direction, offer several advantages over MIIM diodes including negligible capacitance and greater tolerance to high input powers. For carriers to experience the geometric features that promote current asymmetry, their mean-free-path length must be on the order of, or greater than, critical device dimensions. Graphene, with long carrier mean-free-path lengths, is therefore a choice material. By optimizing the geometry of these diodes, their current-voltage characteristics can be made to exhibit large current asymmetries, which is crucial for efficient rectification. The challenge is tuning the geometry to achieve large asymmetries at sufficiently low voltages for efficient operation in rectennas. A Monte Carlo simulator tracked the motion of electrons under an applied bias to determine the current-voltage characteristics for geometric diodes of a specified shape, and various geometries were analyzed to deduce important diode parameters. The current-voltage characteristics were then used in a rectifier circuit simulator to assess attainable rectification efficiencies, and compare them to those of the best projected MIIM diode from a quantum tunneling simulator. The results suggest that geometric diodes may offer improved rectification efficiencies over MIIM diodes for high input powers.
Performance evaluation of an advanced detector module for an RF-penetrable TOF-PET insert for simultaneous PET/MRI

Simultaneous PET/MRI, which combines molecular and anatomical assessment, is a promising multi-modality imaging method. However, the high cost of the current commercial integrated PET/MRI systems limits the long-term potential of PET/MRI imaging. We are studying designs of a PET ring that can be inserted into existing MRI systems in order to reduce the cost without affecting the performance of either the PET or MRI components by leveraging the existing MR infrastructure. We are developing a second-generation RF-penetrable brain-dedicated TOF-PET insert with a trans-axial and axial FoVs of 28 cm and 16 cm, respectively. The PET ring comprises 16 detector modules, each hosting 6 sub-modules. Each sub-module comprises an array of 8 × 16 LYSO crystal elements (3.2 × 3.2 × 20 mm3) one-to-one coupled to an array of SiPMs read out by 4 36-channel readout ASICs. In this work, we evaluated the energy and coincidence timing resolution performance of a detector module, which was thermally regulated by a liquid chiller system at 30 degrees Celsius during the experiments. The energy resolution at 511 keV measured for 256 channels of two sub-modules is 14.3 ± 1.6% (mean ± standard deviation) and coincidence timing resolution measured over two sub-modules is 261.2 ± 28.5 ps FWHM.
Trends in Smoking During Pregnancy in Wisconsin, 2011-2016.

Background Smoking during pregnancy remains a significant public health concern with widespread social, economic, and health effects. Objective To describe the epidemiology of maternal smoking in Wisconsin over time and by county, age, race/ethnicity, education, and other characteristics. Methods Cigarette smoking during pregnancy in 2011-2016 was evaluated using Wisconsin Interactive Statistics on Health data. Results Maternal smoking rates declined from 14.4% in 2011 to 11.4% in 2016. Rates are highest among women aged 20-24 and those with less education. American Indians had the highest rates of smoking during pregnancy at all education levels. Conclusion Despite continued declines in the rates of smoking during pregnancy in Wisconsin, disparities exist for American Indians, young, and less-educated women. Physicians should continue to encourage cessation throughout pregnancy and support evidence-based community programs and policies.
Gender and Minority Considerations in Pharmacy School Student Wellbeing.

The recent article by Babal and colleagues explored first year Doctor of Pharmacy students’ viewpoints on individual, educational system, and health care system factors that affected their wellbeing.[1][1] Workload, learning environment, meaningful pharmacy school experiences, relationships, and