cssi/SciSciGPT-SciSciNet huggingface dataset:
On the flow past a magnetic obstacle

This paper analyses numerically the quasi-two-dimensional flow of an incompressible electrically conducting viscous fluid past a localized zone of applied magnetic field, denominated a magnetic obstacle. The applied field is produced by the superposition of two parallel magnetized square surfaces, uniformly polarized in the normal direction, embedded in the insulating walls that contain the flow. The area of these surfaces is only a small fraction of the total flow domain. By considering inertial effects in the analysis under the low magnetic Reynolds number approximation, it is shown that the flow past a magnetic obstacle may develop vortical structures and eventually instabilities similar to those observed in flows interacting with bluff bodies. In the small zone where the oncoming uniform flow encounters the non-negligible magnetic field, the induced electric currents interact with the field, producing a non-uniform Lorentz force that brakes the fluid and creates vorticity. The effect of boundary layers is introduced through a friction term. Due to the localization of the applied magnetic field, this term models either the Hartmann braking within the zone of high magnetic field strength or a Rayleigh friction in zones where the magnetic field is negligible. Finite difference numerical computations have been conducted for Reynolds numbers Re=100 and 200, and Hartmann numbers in the range 1 ≤ Ha ≤ 100 (Re and Ha are based on the side length of the magnetized square surfaces). Under these conditions, a wake is formed behind the obstacle. It may display two elongated streamwise vortices that remain steady as long as the Hartmann number does not exceed a critical value. Once this value is reached, the wake becomes unstable and a vortex shedding process similar to the one observed in the flow past bluff bodies is established. Similarities and differences with the flow around solid obstacles are discussed.
Solution annealing of poly(TMPS) crystal mats

Poly(tetramethyl-p-silphenylene siloxane) crystal mats initially prepared from benzene/methanol (2:1 v/v), when annealed in small amounts of solvent undergo considerable thickening in the chain direction. When the crystals are annealed above their formation temperature, their physical properties change rapidly at first before reaching an asymptotic limit commensurate with annealing time and type of solvent. Changes in melting temperature, heat of fusion, small-angle x-ray spacing, and wide-angle x-ray scattering patterns have been monitored for three solvents of varying solvent power, ranging from very good to extremely poor. Upon solution annealing, the original crystals mats equilibrate to more stable dimensions compatible with their environment. The activation energy of crystal thickening in contact with a liquid is estimated to be about an order of magnitude lower than that deduced from dry annealing data. It appears that the crystal surface and the crystalline core of the crystals comprising the mats must participate in the measured severalfold increase in long period noted after annealing. The lower surface (or interfacial) energy of the liquid annealed mats compared to isothermally melt-crystallized polymer of similar molecular weight has a direct bearing on the polymer morphology and crystallinity.
Structural Consideration in Designing Organotin Polyethers to Arrest the Growth of Breast Cancer Cells In Vitro

The ability to inhibit cancer is inherent in organotin materials yet the structural relationships that regulate/direct this activity remains unknown. We measured antitumor activity using a matched pair of cell lines MDA-MB-231 cells that are estrogen-independent, estrogen receptor negative and MCF-7 cells, a cell line that is estrogen receptor (ER) positive. Those polyethers that contained a O-phenyl unit were able to significantly inhibit the non-estrogen sensitive cell line but were much less effective against the estrogen sensitive cell line; that is, the human breast cancer cell line MDA-MB-231 showed better test results for polymers derived from diols containing the O-phenyl moiety than the breast cancer cell line MCF-7, a well-characterized estrogen receptor positive control cell line. Those polyethers that did not contain the O-phenyl unit inhibited both cell lines approximately the same. The differential activity of the O-phenyl-containing polyethers is likely due to the estrogen-sensitive cells combining with some of the organotin polyethers minimizing their ability to inhibit cell growth.
Monoamine Oxidase Inhibition and Furazolidone-Induced Cardiomyopathy in Turkey Poults

Abstract Furazolidone (FZ), a potent inhibitor of monoamine oxidase (MAO), fed at concentrations of 700 ppm to turkey poults 2 through 5 weeks of age, produces cardiomyopathy and cardiomegaly. To determine the role of MAO inhibition in FZ-induced cardiomyopathy, the effects of FZ were compared with those of a chemically different MAO inhibitor, tranylcypromine (TCP), and a chemically similar non-MAO inhibitor, nitrofurazone (NFZ). At 14 days of age, poults were divided randomly into four groups. Control poults were fed a standard turkey starter ration, and poults in the experimental groups were fed the standard ration that included one of the following drugs at the given concentrations: 700 ppm FZ, 350 ppm NFZ, or 50 ppm TCP. Activity of MAO was assayed in liver and kidney homogenates from poults chosen at random at 14, 17, 21, 28, and 35 days of age in one trial and on heart homogenates at 14, 15, 17, 19, and 28 days of age in another trial. Development of cardiomyopathy was assessed using an electrocardiographic (ECG) technique and substantiated with necropsy examination. Inhibition of MAO was observed only in the heart in FZ-fed poults, only in the kidney in NFZ-fed poults, and in all three tissues studied in TCP-fed poults. Under the conditions of this study, an increase in the incidence of cardiomyopathy, based on ECG data and necropsy results, occurred only in the FZ-fed group. The inability of the potent MAO inhibitor, TCP, to produce cardiomyopathy in this study supports the conclusion that the primary mechanism of FZ-induced cardiomyopathy in turkey poults is probably not due to MAO inhibition.
An integrated biogeochemical and economic analysis of bioenergy crops in the Midwestern United States

This study integrates a biophysical model with a county-specific economic analysis of breakeven prices of bioenergy crop production to assess the biophysical and economic potential of biofuel production in the Midwestern United States. The bioenergy crops considered in this study include a genotype of Miscanthus, Miscanthusgiganteus, and the Cave-in-Rock breed of switchgrass (Panicum virgatum). The estimated average peak biomass yield for miscanthus in the Midwestern states ranges between 7 and 48 metric tons dry matter per hectare per year (tDMha � 1 yr � 1 ), while that for switchgrass is between 10 and 16tDMha � 1 yr � 1 . With the exception of Minnesota and Wisconsin, where miscanthus yields are likely to be low due to cold soil temperatures, the yield of miscanthus is on average more than two times higher than yield of switchgrass. We find that the breakeven price, which includes the cost of producing the crop and the opportunity cost of land, of producing miscanthus ranges from $53t � 1 DM in Missouri to $153t � 1 DM in Minnesota in the low-cost scenario. Corresponding costs for switch- grass are $88t � 1 DM in Missouri to $144t � 1 DM in Minnesota. In the high-cost scenario, the lowest cost for miscanthus is $85t � 1 DM and for switchgrass is $118t � 1 DM, both in Missouri. These two scenarios differ in their assumptions about ease of establishing the perennial crops, nutrient requirements and harvesting costs and losses. The differences in the breakeven prices across states and across crops are mainly driven by bioenergy and row crop yields per hectare. Our results suggest that while high yields per unit of land of bioenergy crops are critical for the competitiveness of bioenergy feedstocks, the yields of the row crops they seek to displace are also an important consideration. Even high yielding crops, such as miscanthus, are likely to be economically attractive only in some locations in the Midwest given the high yields of corn and soybean in the region.
Conservative Posterior Tooth Restorations

Conservative restorations for posterior teeth (noncrowns) are in a significant evolution, as tooth-colored restorations are showing strong competition for traditional silver amalgam and gold alloy restorations. Resin restorations (direct and indirect inlays and onlays, and directly placed) are major preferences, but porcelain inlays and onlays are favored also. Dentists are advised to inform their patients about the availability of the various types of restorations discussed in this paper. This education will stimulate discussion about their choices and will provide optimum patient satisfaction with the result.
Versatile Task Assignment for Heterogeneous Soft Dual-Processor Platforms

Heterogeneous soft multiprocessor systems are likely to find a larger share in the application-specific computing market due to increasing cost and defect rates in foreseeable manufacturing technologies. We study the problem of mapping streaming applications onto heterogeneous soft dual-processor systems, in which processors' limited memory resources and application throughput form the outstanding constraints and objective, respectively. A key step in the compilation process is task assignment, where tasks are assigned to the processors. We develop a provably-effective algorithm for task assignment. Our algorithm is versatile, in that its formal properties hold for, and hence it is applicable to, a variety of platforms. Measurement of generated code size, and throughput of emulated systems validate the effectiveness of our approach. We advance the state-of-the-art by considerably outperforming two recent competitors in terms of both versatility and application throughput.
Medium energy general purpose collimators (MEGP) are superior over low energy high resolution (LEHR) collimators for I123 imaging

2622 Objectives Recent practice in the nuclear medicine world finds many facilities performing I123 imaging on LEGP collimators. This study seeks to determine whether the practice of using LEHR collimators instead of MEGP collimators for I123 Imaging is an optimal technique. Methods Images of I123 MIBG and I123 NaI Static, WB and phantom images were obtained each directly compared image for the same amount of time. These were reviewed by the Nuclear Medicine Physician and Technologist Staff for feedback regarding better body to background appearance, more clearly defined areas of increased uptake and better contrast and overall appearance in regards to reading for dictation and technical quality control. Results The images obtained on the MEGP collimators were overwhelmingly chosen as the more optimal images when graded according to the factors. Conclusions Facilities that perform I123 Imaging would better serve their patients by acquiring MEGP collimators for I123 Imaging. The practice of acquiring I123 Images on LEHR collimators does not allow for optimal imaging of I123.
Prospective versus Retrospective Rhetoric: Temporal Framing in the Reagan, Clinton, and Bush Administrations

In an attempt to broaden the definition of going public, we develop and test the hypothesis that presidential speech is often more concerned with building prestige through shaping perceptions of current policy than with winning support for new initiatives and that the White House shifts from prospective rhetoric (messages designed to win approval of policy change) to retrospective rhetoric (messages designed to support positive evaluation of previous administration actions) for strategic reasons over the course of a presidency. We test this hypothesis using content analysis of speeches from the Reagan and Clinton presidencies. We argue that this shift helps explain why the utility of presidential persuasion may be underestimated by measures focused only on citizen responses to proposed policy change.
AT-03PHASE I TRIAL OF ENZASTAURIN (LY 317615) IN COMBINATION WITH CARBOPLATIN IN ADULTS WITH RECURRENT GLIOMA

BACKGROUND: Enzastaurin is a selective protein kinase-C β inhibitor with antiangiogenic activity. Preclinical studies support its potential efficacy in combination with carboplatin in high-grade glioma. METHODS: The objective of this open-label phase-I study in adults with refractory high-grade glioma was to determine the maximum tolerated dose, and describe pharmacokinetics of carboplatin in combination with enzastaurin. Patients were stratified based on antiepileptic medication [Group A= nEIAED, Group B = EIAED]. A lead in period with single agent enzastaurin was administered for 7 days (loading dose of 1125 mg Day 1 + 500 mg/d x 6d (Group A); 875 mg/d x 6d (Group B). Each subsequent 28-day-cycle consisted of carboplatin (AUC 3, 4, 5, or 6 Day 1) with enzastaurin (500-875 mg/d Day 1-28). Carboplatin was dose escalated on a 4 + 8 schema. Plasma samples for enzastaurin, its active metabolite-LY326020 and total-platinum were collected at various time points. Adverse events were monitored and graded using NCI CTCAE criteria version 3.0. RESULTS: Fifty-eight patients were accrued (43 Group A;15 Group B). 12 dose limiting toxicities (DLT) occurred in 11 patients (Group-A, 8; Group B, 3). These included lymphopenia (n = 5), deep-vein thrombosis (n = 2), and thrombocytopenia (n = 2). Multi-organ failure resulted in 1 study-related death in Group A. PK analyses were available for 32 patients. Lower area under the plasma concentration time curve ( AUCt), maximum (Cmax ), and average steady-state concentration (Cav,ss) for enzastaurin and LY326020 were noted in Group B. Total platinum exposures [AUC(0-∞)] were generally lower than the targeted AUC but increased with increasing dose, and no differences were observed when given with enzastaurin. CONCLUSION: The maximum tolerated dose of carboplatin in combination with enzastaurin was not reached prior to termination of the study for poor accrual. EIAEDs significantly decreased enzastaurin and its active metabolite. No significant pharmacokinetic interactions were noted between enzastaurin and carboplatin.
Determinants of Rate in Communication Aids for the Non-Vocal Motor Handicapped

A framework is proposed to account for the generic design factors which interact to determine output rate in the use of communication aids for patients with neuromotor speech deficit. These factors, C (cost in language units per word), L (code length in motor acts per unit) and T (time per motor act) are in a trade-off relationship so that an increment or decrement in any one is not sufficient to determine the overall effect on rate of communication. Data is presented from 2 studies to illustrate ways in which this interaction may operate. Implications are drawn for nonvocal communication device design.
Characterization of Circuit Blocks for Configurable Analog-Front-End

Analog functions have been implemented in a Silicon-on-Insulator (SOI) process optimized for high-temperature (>225°C) operation. These include a linear regulator/reference block that supports input voltages up to 50V and provides multiple independent voltage outputs. Additional blocks provide configurable sensor excitation levels of up to 10V DC and/or 20V AC-differential, with current limiting and monitoring. A dual-channel Programmable-GainInstrumentation Amplifier (PGIA) and a high-level AC input block with programmable gain and offset serve signal conditioning, gain, and scaling needs. A multiplexer and analog buffer provide an output that is scaled and centered for down-stream A-to-D conversion. Limited component availability and high component-counts deter development of sensing and control electronics for extreme temperature (>200°) applications. Systems require front-end power conditioning, sensor excitation and monitoring, response amplification, scaling, and multiplexing. Back-end Analog-to-Digital conversion and digital processing/control can be implemented using one or two integrated circuit chips, whereas the front-end functions require component counts in the dozens. The low level of integration in the available portfolio of SOI devices results in high component count when constructing signal conditioning interfaces for aerospace sensors. These include quasi-DC sensors such as thermocouples, strain-gauges, bridge transducers as well as AC-coupled sensors and position transducers, such as Linear Variable Differential Transducers (LVDT’s).Furthermore, a majority of sensor applications are best served by excitation/response voltage ranges that typically exceed the voltage range of digital electronics (either 5V or 3.3V in currently available digital IC’s for use above 200°C). These constraints led Embedded Systems LLC to design a generic device which was implemented by Honeywell as an analog ASIC (Application Specific Integrated Circuit). This paper will describe the ASIC block-level capabilities in the context of the typical applications and present characterization data from wafer-level testing at the target temperature range (225C). This material is based upon work performed by Honeywell International under a subcontract from Embedded Systems LLC funding for which was provided by the U.S. Air Force Small Business Innovative Research program.
Abstract 3673: High-density lipoprotein-like nanoparticles target SR-B1 and inhibit the cellular uptake of melanoma-cell derived exosomes

Exosomes play a crucial role in the progression of cancer through the transport of a variety molecular cargo, including proteins, lipids, and nucleic acids, to and from cells as a means of intercellular communication. Unraveling mechanisms of exosome-cell interactions may open avenues for studying cellular communication and lead to new therapies. Cellular exosome uptake depends on cholesterol-rich membrane microdomains called lipid rafts. Non-specific depletion of lipid raft cholesterol reduces cellular exosome uptake; however, to our knowledge, no targeted mechanism of inhibiting cellular exosome uptake has been reported. Scavenger receptor type B-1 (SR-B1) localizes to lipid rafts, and is a high-affinity receptor for cholesterol-rich high-density lipoproteins (HDL). SR-B1 is an intriguing therapeutic target because it is upregulated in many different cancers due to the high need for cholesterol of rapidly dividing cancer cells. Therefore, we hypothesized that specific targeting of SR-B1 and modulation of cholesterol flux through this receptor with biomimetic HDL-like nanoparticles (HDL NPs) would disrupt cellular exosome uptake. As a model, we explored exosomes derived from melanoma cells as they have been shown to promote angiogenesis and immunosuppression both crucial events in melanoma progression. Melanoma exosomes have also been shown to actively prepare metastatic sites, creating a suitable microenvironment allowing for the development of metastasis. Because of this, targeting exosomes and intercellular signaling could be beneficial for the treatment of metastatic melanoma. Using a variety of techniques including confocal microscopy, flow cytometry and automated image analysis, data demonstrate that HDL NPs specifically target SR-B1 in lipid rafts in melanoma cells and modulate cholesterol flux through this receptor. This leads to a clustering of SR-B1 at the cell membrane and potent inhibition of the cellular uptake of melanoma cell-derived exosomes. Citation Format: Michael P. Plebanek, Alexandre Matov, Kannan Mautharasan, Jesse Gatlin, C. Shad Thaxton. High-density lipoprotein-like nanoparticles target SR-B1 and inhibit the cellular uptake of melanoma-cell derived exosomes. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3673. doi:10.1158/1538-7445.AM2015-3673
Quantitative Investigations of Crystallization Kinetics and Crystalline Morphology Development in Solidifying Polymer Melts with Application to Processing

We have investigated i, the crystallization kinetics and ii, development of crystalline morphology occurring in deforming polymer melts during solidification with special reference to polymer processing.
Synthesizing route travel time distributions considering spatial dependencies

Estimation of route-level travel time distributions (or travel rates) from segment-level data is of great interest today. This paper shows how the random variable properties of comonotonicity and independence can be used in combination to develop such distributions for a wide range of operating conditions. Efficacy of the technique is illustrated using Bluetooth-based travel times collected from individual vehicles on I-5 in Sacramento. The technique offers a way that agencies and other service providers can provide credible travel time (travel rate) distributions to route guidance devices, freight dispatchers and other users who want to know about the reliability of travel time estimates for the routes they utilize.
Group Frequencies and the Chemical Bond

There is a profound dichotomy in the interpretation of infrared and Raman spectra of complex molecules.This has existed for the past thirty years and is only now being resolved in a manner consistant with the needs of both theoretical spectros-copy and analytical chemistry (1).
Quality of life. An important parameter in respiratory tract diseases

Sinusitis is one of the most frequent diseases in humans. Despite severe complications sinusitis may be considered a non-serious disease compared to other illnesses. Therefore, sinusitis is sometimes erroneously regarded as a banal disorder. It is mostly unknown that patients suffering from sinusitis may have a marked impairment of their quality of life (QOL). The term health-related QOL comprises physical and psychological well-being as well as aspects of daily life and social life from the patient's perspective. Validated measures (questionnaires) are able to quantify the impairment of QOL as well as the influence of therapy on QOL. Especially in the treatment of sinusitis, QOL becomes a relevant additional parameter due to the fact that clinical and subjective, patient-based criteria do not correlate sufficiently. This article provides an overview of available QOL questionnaires on sinusitis, highlights results of QOL studies in sinusitis, and elucidates the relevance of QOL in clinical trials as well as in the relation between the physician and the patient.
Von Adenauer bis Schmidt: Wirtschaftslage und Kanzlerpopularität

Das Wirtschaft und Politik eng miteinander verflochten sind, gehort zu den Dingen, die sich von selbst verstehen. Die Stichworte „Weimar“ und „Wirtschaftswunder“ mogen genugen, um dies fur die vorliegende Arbeit zu verdeutlichen. Ohne die wirtschaftliche Not der spaten zwanziger und fruhen dreisiger Jahre last sich der Zusammenbruch der Weimarer Republik kaum vorstellen, ebensowenig das Aufbluhen der Bonner Republik ohne das „Wirtschaftswunder“ der funfziger Jahre. Aber auch in ruhigeren Zeiten wirft die Wirtschaft Licht und Schatten auf die Politik. Kaum etwas last die Regierenden starker um ihr politisches Uberleben zittern als Nachrichten wie z.B., das die Arbeitslosigkeit wieder um 100.000 Personen gestiegen ist oder der Preisindex um ein weiteres Prozent. Sie befurchten, dafur von den Wahlern bei der nachsten Wahl zur Rechenschaft gezogen zu werden. Unter diesen Umstanden erscheint es sinnvoll, einen politisch-okonomischen Zyklus zu postulieren, in dem einerseits die Wahler je nach Wirtschaftslage die Regierenden belohnen oder bestrafen und andererseits die Regierenden die Wirtschaft beeinflussen, um sich der bestmoglichen Reaktion der Wahler zu versichern.1 Das Wahlen je nach Wirtschaftslage gewonnen oder verloren werden, ist ein Glaubenssatz, der bei keiner Wahlberichterstattung fehlt.
Acceleration of cfd and data analysis using graphics processors

Graphics processing units function well as high performance computing devices for scientific computing. The non-standard processor architecture and high memory bandwidth allow graphics processing units (GPUs) to provide some of the best performance in terms of FLOPS per dollar. Recently these capabilities became accessible for general purpose computations with the CUDA programming environment on NVIDIA GPUs and ATI Stream Computing environment on ATI GPUs. Many applications in computational science are constrained by memory access speeds and can be accelerated significantly by using GPUs as the compute engine. Using graphics processing units as a compute engine gives the personal desktop computer a processing capacity that competes with supercomputers. Graphics Processing Units represent an energy efficient architecture for high performance computing in flow simulations and many other fields. This document reviews the graphic processing unit and its features and limitations.
Introduction to Molecular Similarity and Chemical Space

The size of the chemical universe of small organic molecules is estimated to be around 200 billion, and its true size may be even larger. Because the size of “representative” subsets of that universe can still be substantial, computer-based methods are required to capture, manage, and search the massive amount of available chemical information associated with these molecules. This has given rise to the field of chemical informatics. Three concepts play major roles in this field, two of which, molecular similarity and chemical space (CS), are dealt with in this chapter. Of the two, molecular similarity is the more fundamental since it plays a crucial role in the definition of CS itself. The third concept, activity and property landscapes, while important, will not be considered here. Though the potentially relevant subset of molecules that is applicable in food science applications is considerably smaller than the universe of small organic molecules, it nonetheless is large enough to benefit from concepts of molecular similarity and CS that have proved useful in medicinal chemistry and related fields of chemistry. The present chapter provides a relatively detailed and somewhat didactic description of the two concepts, how they are implemented, and how they can be applied in typical chemical applications.
The morality of creating and eliminating duties

We often act in ways that create duties for ourselves: we adopt a child and become obligated to raise and educate her. We also sometimes act in ways that eliminate duties: we get divorced, and no longer have a duty to support our now ex-spouse. When is it morally permissible to create or to eliminate a duty? These questions have almost wholly evaded philosophical attention. In this paper we develop answers to these questions by arguing in favor of the asymmetric approach to deontic value. This approach holds that we must assign zero deontic value (a measure of weight, or stringency) to fulfilling a duty, while assigning negative deontic value to violating that duty. Taking the opposing more natural symmetric approach, which holds that fulfilling duties has positive deontic value, leads to perverse recommendations about when to create or eliminate duties. A formal proof supporting the asymmetric approach is offered. We further show that moral theories require a consequentialist component to explain why we sometimes have duties to create or maintain duties.
Darker days? Recent trends in depression disparities among U.S. adults

Depression is the most prevalent mood disorder in the United States, and disparities in depressive symptoms and treatment by socioeconomic status have been well-documented. Recent evidence suggests the prevalence of depression is increasing, but less is known about time trends in disparities. Using nationally representative data from the National Health and Nutrition Examination Survey, we examined patterns of depressive symptoms (Patient Health Questionnaire-9) and treatment (self-reported psychotherapy and psychopharmacology). We assessed time trends in depression disparities by educational attainment among U.S. adults 2005-2014 using logistic regression models. Among the least educated groups, the odds of moderate to severe depressive symptoms increased; for the most educated, they remained stable (women) or decreased (men). At the same time, odds of receiving treatment, conditional on being depressed, declined (women) or remained stable (men) for the least educated group, whereas treatment rates stayed steady (women) or increased (men) for the most educated. Between 2005 and 2014, overall depression prevalence increased. Despite recent policies designed to improve mental health care coverage, depression treatment rates were unable to keep pace. The least educated consistently had the highest rates of moderate to severe depressive symptoms and the lowest rates of treatment. Disparities in depression by educational attainment have persisted or worsened. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Intellectualizing know how

Following Gilbert Ryle’s arguments, many philosophers took it for granted that someone knows how to do something just in case they have the ability to do it. Within the last couple decades, new intellectualists have challenged this longstanding anti-intellectualist assumption. Their central contention is that mere abilities aren’t on the same rational, epistemic level as know how. My goal is to intellectualize know how without over-intellectualizing it. Intelligent behavior is characteristically flexible or responsive to novelty, and the distinctive feature of creatures who exhibit flexible behavior is their capacity to learn. As it turns out, Ryle already identified a core characteristic of learning shared widely across the animal kingdom from the lowly rat to the top athlete. Taking my cues from Ryle, I argue that know how is successful performance resulting from self-regulated abilities. To regulate an ability is to be disposed to adjust to error and respond to feedback. While regulating sophisticated human abilities often requires propositional knowledge, in many simpler cases it does not. I focus on the navigational know how of rats and honeybees. Although they possess know how, whether they possess propositional knowledge is at best an open question.
Urinary Tract Stones.

1. Caren E. Gellin, MD* 1. *Department of Pediatrics, University of Rochester, Rochester, NY A urinary tract stone, or urolithiasis, is defined as a formation of a stone in the kidney, bladder, or urethra. The epidemiology, imaging modalities, and treatment options for urolithiasis in pediatric patients has significantly evolved in the past several years. Although still more common in adults, the incidence of urolithiasis in children has increased by 6% to 10% annually during the past 20 years, with a current incidence of 36 to 57 per 100,000 US children. The reasons for this change remain unclear, but some hypotheses correlate the increase with obesity and dietary changes. However, current evidence has not confirmed these suspicions. Unlike the male predominance in adults, a strong overall sex preference does not exist in children except that males are more likely to be affected in the first decade of life and females are more likely to be affected in the second decade. Similar to adult stone composition, calcium oxalate and calcium phosphate are the most common stones, composing approximately 75% of cases of pediatric urolithiasis. Other types of stones include struvite, cystine, and uric acid stones. Another important difference between children and adults, which affects diagnostic evaluation and treatment, is that 80% of children have at least 1 risk factor for developing stones, such as abnormal urinary metabolism, a urinary tract infection (UTI), or a structural abnormality. Approximately 50% of children have a metabolic etiology resulting from decreased crystal-forming inhibitors or solute excess from decreased urine volume and/or increased solute excretion. In contrast, risk factors in adults are largely affected by patient dietary habits and comorbidities such as hypertension, diabetes, and obesity. The clinical presentation of urolithiasis varies with …
Abstract 119: Using the VA National Cardiac Device Surveillance Program to Monitor the Safety of Cardiovascular Implantable Electronic Devices

Background: Hundreds of thousands of cardiovascular implantable electronic devices (CIEDs: pacemakers and implantable-cardioverter-defibrillators [ICDs]) have been the subject of Class 1 FDA recall...
Activity-Based Therapy Targeting Neuromuscular Capacity After Pediatric-Onset Spinal Cord Injury

Background: Activity-based therapies aim to improve neuromuscular capacity after spinal cord injury (SCI). Objective: The purpose of this prospective study was to report the impact of Activity-based Locomotor Training (AB-LT) on neuromuscular capacity in pediatric patients with SCI. Methods: Participants were enrolled for their first episode of AB-LT for a minimum of 60 daily, 1.5-hour sessions. The Segmental Assessment of Trunk Control (SATCo) and the Pediatric Neuromuscular Recovery Scale (Pediatric NRS) were assessed initially, every 20 sessions, and post 60 sessions. Results: Twenty-six consecutive patients, mean age 5 years (SD = 3), completed a mean 55 sessions (SD = 4) within 63 weekdays (SD = 9). The Pediatric NRS total score improved significantly, adjusted mean 11.4, from initial to post-60 sessions (p < .05) with an average adjusted evaluation-to-evaluation 3.7 change. SATCo scores improved significantly across 60 sessions, mean change 5.2, an estimated 1.7 change between evaluations (p < .05). Age at enrollment and chronicity had no effect; however, initial neuromuscular capacity scores were negatively correlated with change scores (p < .05). Conclusion: Sixty AB-LT sessions significantly improved trunk and neuromuscular capacity in children with SCI, regardless of age or chronicity at enrollment. Patients with lower initial scores made greater improvements than patients with higher initial neuromuscular capacity. Anecdotal parent reports of their child's functional change in the home and community highlight the synergy between quantitative change in neuromuscular capacity and meaningful, improved quality of life and the need for formal investigation of this relationship.
Post-Pancreatectomy Diabetes Index: A Validated Score Predicting Diabetes Development after Major Pancreatectomy.

Background Literature is varied regarding risk factors associated with diabetes development after major pancreatic resection. The aim was to develop and validate a scoring index that preoperatively predicts the development of diabetes after pancreaticoduodenectomy and distal pancreatectomy. Study Design In this prospective study, perioperative fasting and postprandial (OGTT, oral glucose tolerance test) plasma glucose, glycated hemoglobin A1c (HbA1c), insulin, and c-peptide were measured in select consecutive patients undergoing pancreaticoduodenectomy and distal pancreatectomy by the senior author, from 2007 to 2018. American Diabetes Association definitions were used for glycemic classifications. Statistical analyses included multivariate generalized estimated equation for factor identification and variable weighting; area under the receiver operating curve (ROC) c-statistic for predictive ability, and survival analysis risk score grouping. Results Of 1,083 included patients with preoperative normoglycemia (253; 23.4%), prediabetes (362; 33.4%), and diabetes (468; 43.2%), the overall postoperative incidence of each diabetic class at 120 months was 152 (14.0%), 466 (43.0%), and 465 (42.9%), respectively. The development and validation groups included 1,023 and 60 patients, respectively. Five factors were identified predicting diabetes development, with a total possible score of 8. The C-statistics for development and validation groups were 0.727 (CI 0.696 to 0.759, p Conclusions The Post-pancreatectomy Diabetes Index predicts the development of diabetes and pre-diabetes in patients undergoing major pancreatectomy using routine endocrine laboratories and pre-surgical clinical data.
Securing legal rights to place: mobilizing around moral claims for a houseless rest space in Portland, Oregon

Recent critical scholarship regarding the right to the city suggests that the concept inadequately addresses the function of rights within urban socio-legal processes. This paper draws from various...
Interpretation of the 12-Lead Electrocardiogram in a Young Athlete

A young athlete presents with palpitations and lightheadedness. Tracings from his telemetry and ECGs reveal first degree AV block with occasional second degree Mobitz I, an incomplete right bundle branch block (RBBB) pattern, LVH, and early repolarization. These physiologic ECG abnormalities are more prevalent in male athletes, athletes of African descent, and highly trained athletes.
Empirical evaluation of the association between daily living skills of adults with autism and parental caregiver burden

Background Despite the joy of parenting, the burden of daily caregiving for children with autism spectrum disorders (ASD) can be overwhelming and constant. Parents can expect to provide enduring care for their children with ASD. Given that the majority of individuals with autism spectrum disorders (ASD) remain in their family homes well into adulthood, often the need for assistance with activities of daily living (ADLs) is placed on parents. Providing ongoing support to adult children who have difficulty with completing ADLs can increase parental caregiving demands. Therefore, the purpose of this study was to examine the relationship between the ability of adults with ASD to perform ADLs with parental perceptions of caregiver burden. Methods Quantitative analysis of cross-sectional multi-state data gathered electronically using Qualtrics from 320 aging parents of adults with ASD was conducted. Regression models were fit to examine the association of ADL challenges with total caregiver burden and its four domains (emotional, financial, time dependence, and developmental). Results Parental perceptions of caregiver burden decreased, particularly time dependence and developmental burden, when adult children were less dependent in ADLs, even after adjusting for parental health and behavioral challenges. Conclusions Findings support the need for family-centered interventions to improve the capacity of adults with ASD to perform ADLs independently.
Conversing with High-Risk Patients to Determine Serious Illness Goals and Values in the Time of Covid-19

Brigham Health developed an approach to identify and document the goals and wishes of patients at high risk of impact from Covid-19–related illness by using algorithms, discussion guides, and diver...
Examining an Activity System of Learners, Tools, and Tasks in a Video Club

Science education reform documents call for shifts in instruction that promote more student-centred instruction. Current science teachers often lack experience with this form of instruction, both as teachers and as learners. Video can provide models of desired instruction as well as provide ways for teachers to study classroom practice intensively. However, the importance of facilitation and practices to promote participant collaboration and focus has been identified as a critical factor in promoting teacher learning with video. Various frameworks exist that elaborate effective facilitation moves and practices. Yet, these facilitation frameworks do not consider the facilitation of video over time in response to participant learning, tool development, and changing tasks. Using an activity theory framework to analyse the interplay of tools, tasks, and talk, this chapter describes how facilitation in a video club with high school science teachers shifted over the course of a semester. This chapter explores explicitly how facilitation moves functioned differently during the video club series. While facilitation in early phases promoted trust-building and norm-setting as they analysed videos of others’ instruction, facilitation in middle and late phases promoted increased reliance on video-based evidence and analytic tools to support participants’ claims. In addition, facilitation in late phases saw a return to trust-building as participants began to analyse videos of their own teaching. The results of this analysis shed light on how the designers and facilitators of video-based professional development might plan for the shifting learning demands of participants, and the affordances of tools and tasks they engage with over time.
Implementation of near‐universal hydroxyurea uptake among children with sickle cell anemia: A single‐center experience

BACKGROUND Without early initiation of disease-modifying therapy, the acute and chronic complications of sickle cell anemia (SCA) begin early in childhood and progress throughout life. Hydroxyurea is a safe and effective medication that reduces or prevents most SCA-related complications. Despite recommendations to prescribe hydroxyurea for all children with SCA as young as 9 months, utilization remains low. PROCEDURE We completed a retrospective review of hydroxyurea-prescribing practices and associated clinical outcomes at our institution over a 10-year period before and after the 2014 National Heart, Lung, and Blood Institute (NHLBI) recommendations to use hydroxyurea for all children with SCA. RESULTS Hydroxyurea use more than doubled within our pediatric SCA population from 43% in 2010 to 95% in 2019. The age of hydroxyurea initiation was significantly younger during 2014-2019 compared to 2010-2013 (median 2 years vs. 6 years, p ≤ .001). With this change in clinical practice, nearly all (69/71 = 97%) children born after 2013 received disease-modifying therapy by the end of 2019, primarily hydroxyurea (93%). Concurrently, the number of SCA-related admissions significantly decreased from 67/100 patient-years in 2010 to 39/100 patient-years in 2019 (p < .001). CONCLUSION The early and universal prescription of hydroxyurea for children with SCA is the standard of care. Here, we demonstrate that a careful and deliberate commitment to follow this guideline in clinical practice is feasible and results in measurable improvements in clinical outcomes. Our approach and improved outcomes can serve as a model for other programs to expand their hydroxyurea use for more children with SCA.
Research on Nature, Prevalence, and Characteristics in Mental Health Disorders and Functional Assessment

Psychiatric disorders are mental health conditions where an individual displays a behavioral or mental pattern that causes significant distress or impairment in personal or social functioning. Many psychiatric disorders can occur across the lifespan, with some being more likely in childhood and others being rare until adulthood. Psychiatric symptoms are influenced by one’s genetics and biology, as well as social and environmental influences. With that in mind, functional assessment has a role in identifying and assessing the intersection of biopsychosocial functioning and cognitive, emotional, and behavioral symptoms as it relates to a person’s mental health and overall wellness. The purpose of this chapter is to provide an introduction into the incorporation of functional assessment for psychiatric disorders. An overview of those conditions, or symptom clusters, where the utility of functional assessment has been established will be discussed first, followed by conditions where functional assessment has emerging utility.
Towards The Development of Subject-Independent Inverse Metabolic Models

Diet monitoring is an important component of interventions in type 2 diabetes, but is time intensive and often inaccurate. To address this issue, we describe an approach to monitor diet automatically, by analyzing fluctuations in glucose after a meal is consumed. In particular, we evaluate three standardization techniques (baseline correction, feature normalization, and model personalization) that can be used to compensate for the large individual differences that exist in food metabolism. Then, we build machine learning models to predict the amounts of macronutrients in a meal from the associated glucose responses. We evaluate the approach on a dataset containing glucose responses for 15 participants who consumed 9 meals. Three techniques improve the accuracy of the models: subtracting the baseline glucose, performing z-score normalization, and scaling the amount of macronutrients by each individuals’ body mass index.
Concurrent validity and precision of the thumb disability examination (TDX) in first carpometacarpal osteoarthritis

Abstract Study Design A descriptive psychometric study of precision and concurrent validity of the Thumb Disability Examination (TDX). Introduction Thumb carpometacarpal osteoarthritis (CMC OA) is a painful joint condition impacting the functionality of the hand. Therapists use patient-reported outcome measures to evaluate change in disability and symptomology in response to interventions. The TDX is the only condition-specific outcome measure for persons with thumb CMC OA. Its responsiveness, test-retest reliability and concurrent validity with the DASH are published, yet it's precision and concurrent validity with a hand-region-specific tool has not yet been established. Purpose of the Study We aimed to determine the precision and concurrent validity of the TDX with a region-specific outcome measure in people with thumb CMC OA. Methods Sixteen individuals with a medical diagnosis of CMC OA or a positive pressure-shear test completed the TDX across two visits and the Brief Michigan Hand Questionnaire (bMHQ) at the initial visit. The second visit was 7 to 21 days after the first. Self-administration of the TDX and bMHQ were observed by a licensed occupational therapist. Results Across total and subscale scores of the TDX, standard error of measurement (SEM) values are used to indicate the precision of tool and demonstrate how confident a user can be that change in score exceeds the error inherent to the tool. Minimal detectable change percentage (MDC%) values for the TDX are acceptable ( Discussion Precision of the TDX is acceptable and the concurrent validity of the TDX with a commonly used region-specific scale is high. The study was limited by a small, demographically homogeneous sample due to difficulty in recruitment. Conclusions The TDX is a precise and valid outcome measure for individuals having a clinical diagnosis or indications of having thumb CMC OA.
Local manganese chloride treatment accelerates fracture healing in a rat model.

This study investigated the effects of local delivery of manganese chloride (MnCl2), an insulin-mimetic compound, upon fracture healing using a rat femoral fracture model. Mechanical testing, histomorphometry, and immunohistochemistry were performed to assess early and late parameters of fracture healing. At 4 weeks post-fracture, maximum torque to failure was 70% higher (P < 0.05) and maximum torsional rigidity increased 133% (P < 0.05) in animals treated with 0.125 mg/kg MnCl2 compared to saline controls. Histological analysis of the fracture callus revealed percent new mineralized tissue was 17% higher (P < 0.05) at day 10. Immunohistochemical analysis of the 0.125 mg/kg MnCl2 treated group, compared to saline controls, showed a 379% increase in the density of VEGF-C+ cells. In addition, compared to saline controls, the 0.125 mg/kg MnCl2 treated group showed a 233% and 150% increase in blood vessel density in the subperiosteal region at day 10 post-fracture as assessed by detection of PECAM and smooth muscle α actin, respectively. The results suggest that local MnCl2 treatment accelerates fracture healing by increasing mechanical parameters via a potential mechanism of amplified early angiogenesis leading to increased osteogenesis. Therefore, local administration of MnCl2 is a potential therapeutic adjunct for fracture healing. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:122–130, 2015.
Recurrent coronary artery fistula

A patient with a large fistula from the left circumflex coronary artery to the coronary sinus that recurred in spite of proximal and distal ligation is presented. It suggests that ligation is not an adequate procedure for large coronary fistulae. Division and oversewing should be done whenever feasible.