cssi/SciSciGPT-SciSciNet huggingface dataset:
Does a prophylactic dose of propofol reduce emergence agitation in children receiving anesthesia? A systematic review and meta-analysis.

SummaryIntroduction Emergence agitation (EA) is common after sevoflurane anesthesia in children, and can lead to distressing inconsolability, agitation, crying, and injury. Use of a single dose of the short-acting sedative-hypnotic agent propofol at the end of a procedure has shown promise for preventing EA, but evidence evaluating the efficacy and safety of this approach has not been formally summarized. Objective The objective of this review was to assess the effects of a prophylactic dose of propofol vs placebo on the incidence and severity of EA in children age 0–13 years receiving general inhalational anesthesia. Search methods We searched PubMed (1946–2013) via Medline, CENTRAL (1898–2013), and Web of Science (1900–2013) without limits or language restrictions; we also searched ClinicalTrials.gov and reference lists. We reviewed abstracts from the 2012 and 2013 Society for Pediatric Anesthesia meetings and pediatric anesthesia-related abstracts from the 2012 and 2013 International Anesthesia Research Society meetings. Selection criteria We assessed randomized, double-blind trials evaluating the efficacy of a prophylactic dose of propofol (1 mg·kg−1) vs placebo given at the end of inhalational anesthesia to prevent EA in pediatric patients. Studies were required to follow patients through recovery and report at least one prespecified outcome. Data collection and analysis Two authors independently assessed trial quality and extracted data from included studies. We contacted study authors regarding any missing data. We used the random effects models to calculate pooled relative risks (RR) and weighted mean differences (WMD). We collected Pediatric Anesthesia Emergence Delirium (PAED) scale scores from included studies. PAED scale scores can range from 0 to 20. Main results Of 276 studies screened, nine trials involving 997 children met all inclusion criteria. All were considered low risk of bias. For one non-English trial, we obtained a full-text translation and for one non-English trial, we used the English-language abstract, tables, and figures. Based on available evidence, prophylactic propofol was associated with both decreased incidence of EA (29% vs 58%, RR 0.50, 95% confidence intervals [CI] 0.41, 0.61, I2 = 37%, seven studies), and reduced severity of EA as assessed by mean PAED scale score (WMD −2.08 points, 95% CI −3.20, −0.96, I2 = 0%, three studies), when compared to placebo. In addition, though prophylactic propofol did lengthen the time to awakening (WMD 4.07 min, 95% CI 2.22, 5.91, I2 = 82%, six studies), it did not increase recovery time (WMD 2.91 min, 95% CI −0.59, 6.41, I2 = 82%, six studies) when compared to placebo. No significant adverse events were reported in either arm. Conclusion Based on high quality evidence, prophylactic propofol appears to be effective for reducing the incidence and severity of EA in children emerging from general anesthesia.
Smart X‐ray beam position monitor system using artificial‐intelligence methods for the Advanced Photon Source insertion‐device beamlines

At the Advanced Photon Source (APS), each insertion-device (ID) beamline front end has two X-ray beam position monitors (XBPMs) to monitor the X-ray beam position for both vertical and horizontal directions. Performance challenges for a conventional photoemission-type XBPM during operations are contamination of the signal from the neighbouring bending-magnet sources and the sensitivity of the XBPM to the insertion-device gap variations. Problems are exacerbated because users change the ID gap during their operations, and hence the percentage level of the contamination in the front-end XBPM signals varies. A smart XBPM system with a high-speed digital signal processor has been built at the Advanced Photon Source for the ID beamline front ends. The new version of the software, which uses an artificial-intelligence method, provides a self-learning and self-calibration capability to the smart XBPM system. The structure of and recent test results with the system are presented in this paper.
Picosecond Intermediates in the Bacteriorhodopsin Photocycle

The molecular mechanism(s) by which bacteriorhodopsin (BR) utilizes the radiative energy in the visible region absorbed by the retinal chromophore is of major importance in characterizing the bacterial photocycle and the associated transport of protons across the BR membrane. The changes in retinal structure, electronic properties, and conformation which occur within the first 100 ps following excitation are examined here using time-resolved resonance Raman (TR3) and fluorescence (TRF) spectroscopies with 5 ps time resolution. TR3 spectra identify at least one major change in retinal structure (all-trans to 13-cis isomerization) occurring during the first 40 ps of the reaction, while TRF spectra reveal previously unreported fluorescence from a BR intermediate. These TR3 and TRF data are used to construct a model for retinal dynamics over the initial 100 ps interval of the BR photocycle.
Climatology of Back Trajectories from Israel Based on Synoptic Analysis

Abstract The Air Resources Laboratory's trajectory model was used to calculate five-day back trajectories from Israel at the 850 mb pressure surface for five years (January 1978–December 1982). These air flow patterns were evaluated in conjunction with seasonal weather types for which a detailed synoptic analysis and classification of the weather situations prevailing during these air flow patterns has been performed. A significant difference between the typical seasonal trajectories is pointed out. Trajectories reach Israel from five major source regions: 1) northwest Europe; 2) eastern Europe; 3) Saudi Arabia and Jordan; 4a) North African coast; and 4b) inland North Africa.
A Concise History of International Finance: The Bretton Woods era and the re-emergence of global finance, 1945–1973

The Bretton Woods Conference in 1944 was an ambitious initiative by the US to reshape the post-war international economy in ways that would avoid the confusion and obvious mistakes that had been made after the First World War. This time, instead of withdrawing into isolation from the problems of post-war adjustments and inadvertently making them worse by setting unrealistic goals, the Roosevelt administration was determined to maintain in peacetime the leadership it had acquired during the war. A piece of doggerel on a scrap of paper found after one of the meetings, “Said Lord Halifax to Lord Keynes, they have the money bags, but we have the brains!” expressed another view. From the British perspective, the US would benefit from the imperial experience of the mother country on how to use its economic hegemony constructively. For Keynes, this meant providing international liquidity in a structured way rather than the ad hoc procedures that had eventually been cobbled together after the First World War. But even that fragile structure had then led to five good years of international prosperity, so it seemed worth constructing something similar but sooner and more solidly. In Keynes' view, countries could commit to fixed exchange rates with each other by buying into the capital stock of an international bank, set up to issue its own currency, the bancor , which would have a fixed value in terms of gold. Each country with accounts denominated in bancor could use them to settle international accounts with each other. (Readers of Chapter 3 will recall how the Wisselbank in Amsterdam created just such a system for financing European international trade in the seventeenth and eighteenth centuries with its schellingen banco defined in terms of silver and gold.) The US negotiators in Washington from the Treasury were suitably impressed by this vision (Harry Dexter White, Assistant Secretary of the Treasury, had written his PhD thesis on the French experience with the gold standard in the nineteenth century), but they insisted that the US, which necessarily would be the largest shareholder with the largest existing stock of gold on hand and with the US dollar still fixed at $35.00 per ounce of gold, would have to keep control of the purse strings.
A time-domain equivalent source method for acoustic scattering with coincident source and control points

T he ability to predict acoustic scattering from hard surface reflections in the vicinity of an exhausting jet is important to attempts at predicting the spatial effects of various engine and nozzle configurations. A time-domain equivalent source method is presented similar to Lee’s method for predicting acoustic scattering due to hard surface reflections using acoustic gradient predictions from the G1A formulation. In contrast to Lee’s method, the approach proposed here involves using source and control points that are coincident, leading to improvements in performance for some geometries. The most advantageous case appears to be for planar surfaces, where interaction between sources is avoided. Validation cases considered include a series of planar segments for analytical validation as well as cases to validate the use of the G1A inputs in connection with the our proposed method, and a series of scattering cases using an acoustic data surface as input to the model.
Graphene-Based Chemical Sensors.

Pioneering research in 2004 by Geim and Novoselov (2010 Nobel Prize winners in Physics) of the University of Manchester led to the isolation of a monolayer graphene sheet. Graphene is a single-atom-thick sheet of sp2 hybridized carbon atoms that are packed in a hexagonal honeycomb crystalline structure. Graphene is the fundamental building block of all sp2 carbon materials including single-walled carbon nanotubes, mutliwalled carbon nanotubes, and graphite and is therefore interesting from the fundamental standpoint as well as for practical applications. One of the most promising applications of graphene that has emerged so far is its utilization as an ultrasensitive chemical or gas sensor. In this article, we review some of the significant work performed with graphene and its derivatives for gas detection and provide a perspective on the challenges that need to be overcome to enable commercially viable graphene chemical sensor technologies.
The Impact of Residual Risk and Resultant Problems on ISD Project Performance

This research investigates the impact of residual risk that remains after implementing risk interventions to cope with the high uncertainty of information systems development (ISD) projects. This r...
Implementing Evidence-Based Guidelines The Role of Ambulatory Care Pharmacists

Pharmacists strive to align patients' medication regimens with evidence-based guidelines through medication therapy management and through the utilization of protocols based on best practices for chronic disease management. Ambulatory care pharmacists also assist in implementing guidelines through developing evidence-based algorithms and processes, educating providers and staff, and participating in population management.
A Review of the Use of Group Contingencies in Preschool Settings

Individual contingency management systems have been used successfully to improve behaviors in school settings—including preschools—but often come with associated challenges in time and personnel management. Group contingencies, in the form of independent, interdependent, and dependent contingencies, have been used in preschools to address these challenges. Although current reviews exist on the positive effects of these interventions with older students, none exist to date on the effects on preschool children. The purpose of this review was to synthesize the research on the use of group contingencies in preschool classrooms. Clear trends emerged across studies regarding characteristics of participants, type of contingency used, intervention components, and rewards.
Review: erythropoietin or darbepoetin for anemia in patients with cancer produces both benefits and harms with no increase in survival.

Source Citation Bohlius J, Wilson J, Seidenfeld J, et al. Erythropoietin or darbepoetin for patients with cancer. Cochrane Database Syst Rev. 2006;(3):CD003407. 16856007
Hybrid HTS and III-V Microwave Oscillators

Low-noise oscillators operating as pure microwave frequency sources have many critical real world uses in modern radar, communications, and information processing applications. One such application would be as a local oscillator in an advanced microwave front-end receiver. Hybrid oscillators consisting of III-V FETs and high temperature superconducting (HTS) passive microwave devices have been fabricated and tested at cryogenic temperatures at Du Pont. Initial devices operating in the C-band at 4.7 GHz have utilized commercially available High Electron Mobility Transistor (HEMT) unpackaged chips. Wide band amplifiers with bandwidth from 2 to 8 GHz were fabricated and tested at 77 K show 17 dB gain. This is 3 dB higher than amplifiers operating at room temperature. Hybrid oscillators were fabricated using these wide-band amplifiers with feed back provided by a Tl2Ba2CaCu2O8 microstrip resonators. Resonators were fabricated from two-side coated HTS films on LaAlO3 substrates and had loaded Qs of 5000 with insertion loss of -6 dB. Oscillators show phase noise of less than -106 dBc (1 Hz) at 10 KHz offset from operating frequency of 4.7 GHz.
Water-Soluble Osmium Complexes Suitable for use in Luminescence-Based, Hydrogel-Supported Sensors

Osmium transition metal complexes are of particular interest in luminescence-based sensing applications because of their longer wavelength absorptions and emissions, relative to similar ruthenium and rhenium complexes, that allow for inexpensive excitation and minimize interferences from autofluorescence when the sensor is used in biological samples. Reported here are the photophysical properties of a series of water-soluble osmium complexes suitable for use in hydrogel-based sensors: [Os(bpy)2(sulf-dpp)]Cl2, [Os(phen)2(sulf-dpp)]Cl2, [Os(dpp)2(sulf-dpp)]Cl2, and [Os(CO)2Cl2(sulf-dpp)], where bpy is 2,2′-bipyridine, phen is 1,10-phenanthroline, dpp is 4,7-diphenyl-1,10-phenanthroline, and sulf-dpp is bathophenanthrolinedisulfonic acid disodium salt. The family of complexes showed minimal oxygen quenching, making them particularly well-suited for sensing applications in which oxygen concentration varies. Luminescence anisotropy was found to depend more significantly on net dipole moment than hydrodynamic radius of the molecule, and, as expected, excited state lifetime and luminescence anisotropy were highly dependent on the local environment of the reporter molecule. Results obtained for hydrogel-based relative humidity sensors containing [Os(CO)2Cl2(sulf-dpp)] and [Os(bpy)2(sulf-dpp)]Cl2 complexes highlight the significant potential for this class of compounds in a hydrogel-supported luminescence-based sensing approach.
Thermal modelling of coaxial line for cryogenic noise measurements

A numerical model is used for accurately calculating the temperature along a coaxial line with ends at different cryogenics temperatures. The calculations take into account the variation of thermal and electrical conductivity with temperature, an important consideration not present in previous publications. Estimates of line attenuation and added noise temperature can be more accurately calculated using this profile, and the profile can provide insight into thermal clamp position and thermal loading calculations. These calculations have a significant impact on the accuracy of variable temperature load and cold attenuator noise measurements.
Understanding and Teaching the Most Probable Number Technique

The most probable number (MPN) technique is extensively used in food microbiology. However, because statistics involved often are cumbersome and it is difficult to obtain some of the widely scatter...
Policies of acceptable use at educational and research institutions

Were codes of computer ethics at educational and research institutions any different from those of professional societies? Modelled upon the Berleur/d’Udekem-Gevers survey of codes of ethics of professional societies, in this book, we embarked upon a journey to examine collections of codes of computer ethics developed at different colleges, universities and research centers. We were interested to learn the following about such codes: What was the general form of a code of computer ethics? Were there any similarities to be found between the codes? Were there any trends in ethical philosophy at work here?
Mechanisms of Hypercalcemia in Non-Hodgkin Lymphoma and Associated Outcomes: A Retrospective Review

Abstract Introduction The etiology of hypercalcemia in non-Hodgkin lymphoma (NHL) has been most often attributed to either elevated serum levels of 1,25-dihydroxycholecalciferol (calcitriol) or parathyroid-related protein (PTHrP). In a single-center retrospective review, we evaluated the incidence of, and outcomes associated with, hypercalcemia in NHL. Patients and Methods The medical records of patients with a histologically confirmed diagnosis of NHL and ≥ 1 episode of hypercalcemia were evaluated for demographic and lymphoma-specific factors, including the response to therapy and overall survival. Results Fifty-four patients with NHL met the inclusion criteria. Most patients (57.4%) had diffuse large B-cell lymphoma, of which, 70% were the nongerminal center subtype. Approximately one half (42.6%) of the included patients had undergone serologic investigation into the etiology of hypercalcemia; however, only 17 patients (31.5%) had both a serum PTHrP and a calcitriol level properly collected. Of the 17 cases for which both a serum calcitriol and a PTHrP were collected, most (61.1%) were found to have neither an elevation of serum calcitriol nor an elevation of PTHrP. The degree of calcitriol elevation correlated with worse progression-free survival ( P = .04) but not overall survival. Conclusion The major mechanism by which NHL patients develop hypercalcemia is not mediated by calcitriol or PTHrP. Hypercalcemia is most prevalent in patients with diffuse large B-cell lymphoma of the nongerminal cell subtype. Patients with calcitriol-mediated hypercalcemia showed a trend toward worse outcomes, suggesting that calcitriol might be a marker of high-grade lymphoma, transformation to such, or a surrogate for more advanced disease.
Therapists’ perceptions of the 3:1 Service Delivery Model: A workload approach to school-based practice

ABSTRACTIn recognition of their many roles, school-based practitioners have been encouraged to reframe their job-related responsibilities in terms of their workload, rather than their caseload. The...
Advances in PhET Interactive Simulations: Interoperable and Accessible

Over more than a decade, the PhET Interactive Simulations project has created a suite of interactive simulations (sims) that support learning of science and mathematics content through exploration and discovery. Here we describe the state of the art in interactive science simulations, historical innovations that enabled this state, and current initiatives to advance the field.
Guest Editorial Special Issue on Plenary, Invited & Selected Minicourse Papers From ICOPS 2017

The IEEE International Conference on Plasma Science (ICOPS) is one of the premier professional meetings of plasma scientists from all over the world. The conference program showcases the most recent basic research discoveries in plasma science while emphasizing the various new applications and technologies of plasmas. This international conference is annually sponsored by the Plasma Science and Applications Committee (PSAC) of the IEEE Nuclear and Plasma Science Society (NPSS).
Mode switching in control of accommodation

The block diagram describes the functioning of a four mode control system model for ACC that is switched among one or more of these operational modes. Blur controls certain switchings between modes dependent upon upper and lower thresholds for detection of blur. Blur is the “sufficient” neurological control signal; other clues to distance may supplement, but not supplant blur. Acceptance of a residual detectable blur error signal is characteristic of “hill climbing”.
EVIDENCE FOR SUBAERIAL ACTIVITY OF EUPROOPS DANAE (MEROSTOMATA, XIPHOSURIDA)

ABSTRACT Euproops danae , the most common of the Mazon Creek horseshoe crabs, is generally regarded (along with other Carboniferous euproopids) as having been exclusively aquatic. However, in coal swamp faunas where terrestrial and aquatic assemblages can be distinguished, Euproops occurs much more frequently with the presumably terrestrial elements than with the aquatic elements. Although it is possible to reconcile this distribution with exclusively aquatic habits, other lines of evidence are not as easily set aside. A detailed resemblance between the genal and ophthalmic spines of E. danae and the foliage of some arborescent and herbaceous lycopods, considered together with certain aspects of appendage mechanics, suggests that E. danae habitually crawled along, or clung to, lycopod twigs, probably in a subaerial setting. Similar mimetic relationships existed between other euproopids and other elements of the coal swamp flora. At least occasional subaerial activity is suggested by another case of possible mimesis, between E. rotundatus and an arachnid, Maiocercus carbonis , and also by the occurrence of some euproopids in the sedimentary infilling of an upright lycopod stump. A final line of evidence concerns associations of E. danae with millipedes and scorpions, in a characteristic type of ‘coprolitic’ concretion in the Braidwood fauna. Bivalves and aquatic crustaceans also occur in coprolitic concretions, but in ones of a different type, with which E. danae , millipedes, or scorpions are never associated. It seems likely that, in addition to their relatively extensive aquatic activity (within a brackish-fresh water setting), euproopids were regularly present in a subaerial context, probably remaining among moist litter on the forest floor, on low vegetation, or on mats of floating plant debris. This approach to reconstructing the behavior of fossil organisms concentrates on evidence that is directly applicable to the case under investigation and utilizes arguments that are relatively deductive in character. There will always be problems inherent in evaluating hypotheses for behavioral reconstruction, but this strategy does avoid some of the intrinsic logical problems of more inductive approaches.
The Pulse Line Ion Accelerator Concept

April 3, 2006 LBNL-59492 The pulse line ion accelerator concept Richard J. Briggs Science Applications International Corporation, Alamo, California, 94507 The Pulse Line Ion Accelerator concept was motivated by the desire for an inexpensive way to accelerate intense short pulse heavy ion beams to regimes of interest for studies of High Energy Density Physics and Warm Dense Matter. A pulse power driver applied at one end of a helical pulse line creates a traveling wave pulse that accelerates and axially confines the heavy ion beam pulse. Acceleration scenarios with constant parameter helical lines are described which result in output energies of a single stage much larger than the several hundred kilovolt peak voltages on the line, with a goal of 3-5 MeV/meter acceleration gradients. The concept might be described crudely as an “air core” induction linac where the PFN is integrated into the beam line so the accelerating voltage pulse can move along with the ions to get voltage multiplication. 1. Introduction In the “Pulse Line Ion Accelerator” (PLIA) concept described in this paper a ramped high voltage pulse is applied at the input end of a helical pulse line structure. The resulting traveling wave pulse on the line can accelerate an ion bunch to energies much greater than the peak voltage applied to the line. It should also be possible to achieve an axial acceleration gradient of several MeV per meter with realistic helix parameters. The development of this concept was originally motivated by a proposal to use moderate energy intense ion beams to heat matter to regimes of interest for studies of High Energy Density Physics (HEDP) and Warm Dense Matter (WDM) [ 1 ] . In this approach, very short pulses (~ a nanosecond or less) of “medium mass” ions with energies slightly above the Bragg peak are focused to mm scale spot sizes onto thin target “foils”, which may in fact be foams with mean densities of order 10% solid density or less. The high degree of uniformity and efficiency with volumetric and shock-less heating of the target to temperatures of order 1 to 10 eV are attractive features in this approach. The concept presented in this paper is an excellent fit to the accelerator requirements for this HEDP/WDM application. A helical pulse line inserted into a large bore 5 - 10T superconducting solenoid can transport and accelerate a singly charged Ne or Na ion bunch with a total charge of order 0.1 to 1 micro-coulombs, an axial bunch length of 10’s of cm, and a radius of a few cm. The required axial compression to bunch lengths of order one cm in a neutralized drift compression region following the accelerator is then only a factor of 10-30, which greatly eases the requirements on longitudinal emittance, velocity tilt, and drift distance.
Mathematical model for predicting calcareous film formation

A previously developed mathematical model describing the formation of calcareous deposits on cathodically protected steel in seawater has been improved. By entering geographical coordinates of interest and a time duration, current density requirements and surface coverage of calcareous deposits as a function of time and depth are predicted. From this data, surface plots of current density requirements and calcareous deposit coverage can be easily created. The data can also be used to construct polarization curves, which can be used as input into a cathodic protection model for calculating the number and size of sacrificial anodes required for successful cathodic protection of offshore steel structures.
Matrix and Particle Size Effects in Analyses of Light Elements, Zinc through Oxygen, by Soft X-Ray Spectrometry

With the development of soft X-ray sources by Henke, it is now possible to extend the range of quantitative analyses by X-ray spectrometry into the very light element range (magnesium through boron). Techniques of specimen preparation, recognized as one of the most critical aspects of quantitative X-ray analysis in the heavier elemental ranges, present new problems, especially with the physically and chemically heterogeneous materials encountered in mineral and rock analysis. This paper presents the results of new tests extended into the light and very light element range. It is shown that most of the problems previously found are intensified as lower atomic number elements are considered; conditions of the specimen surface are critical and require precise control of particle size. In addition, significant absorption by relatively heavier elemental constituents, either in a separate phase or within the same phase, causes poor precision and is difficult to predict. Thus, the combination of matrix absorption within and between discrete phases, combined with the difficulty of grinding different phases to a uniform particle size, suggests that fusion techniques are required for best precision. Without fusion, both scatter and bias are introduced through non-linear calibrations, with each calibration dependent upon specimen composition and particle size. It is concluded that only with nearly uniform specimens, where gross deviations are to be checked (e.g., process control) can ground rock powders be used with success in light element analyses.
The land inside: Mapuche memory and territory in Adriana Paredes Pinda’s Parias Zugun

In recent decades, the Mapuche people’s demand for the return of ancestral territories has intensified. This article examines how Adriana Paredes Pinda’s poetry anthology Parias Zugun gives voice t...
The prevalence and awareness of sleep apnea in patients suffering chronic pain: an assessment using the STOP-Bang sleep apnea questionnaire

Purpose Some patient subsets are at higher risk of sleep apnea, including patients with chronic pain. However, it is unclear whether patients and their caregivers are aware of the possibly increased risk of sleep apnea in this population. Chronic pain is often treated with opioids which may decrease both the central respiratory drive and the patency of the upper airway, potentially contributing to this sleep disorder. Using a self-reporting questionnaire approach in the chronic pain population, this study surveyed patient and caregiver awareness surrounding the risk of sleep apnea. In addition, we looked at the influence of opioid therapy on the prevalence of sleep apnea. Participants and methods Consecutive patients presenting to a pain clinic were invited to participate anonymously in a survey that included the STOP-Bang sleep apnea questionnaire, which assesses patients' knowledge, testing, diagnosis, or treatment of sleep apnea and whether their caregivers had discussed with them their increased risk of sleep apnea and opioid use. Results Among 305 participating patients, 58.2% (n=173) screened positive for sleep apnea. Among the 202 patients on opioid therapy, 59.2% (116/202) were STOP-Bang positive (score ≥3). However, only 37.5% (n=72/173) of these patients had discussed their risk of sleep apnea with a caregiver and only 30.7% (n=59) underwent testing. Against expectation, opioids did not increase the prevalence of sleep apnea in our study population. Conclusion Chronic pain patients had a high risk of sleep apnea, regardless of opioid prescription. Most patients were unaware of their increased risk and denied undergoing the necessary testing. Greater attention to screening, testing, and education for sleep apnea needs to be paid in chronic pain patients, especially given the potentially dangerous ramifications of opioid-induced sleep apnea.
The Architect’s Dilemmas

The creation of a cognitive architecture presents the architect with many design choices. Some of these choices come in the form of a dilemma, in which the selection of any option over another entails both benefits and opportunity costs. This chapter highlights three dilemmas that confront the architect when deciding how the key issues of fidelity, embodiment, and autonomy should be addressed and reflected in the design. In each case, it discusses the various options, their roots, and the consequences and costs of choosing one option over another. It concludes by considering these three dilemmas in the context of the stance on cognitive adopted by the editors of this book.
A primer on cost-effectiveness in the allergy clinic

Abstract Objective To provide a cost-effectiveness primer for the practicing allergist. Data Sources Articles assessing use of decision analysis and cost-effective healthcare delivery. Study Selections A narrative review detailing approaches to incorporate evidence based medicine into individualized patient-centered cost-effective practice. Results Resources in medicine are finite and it has been estimated that more than 30% of healthcare spending is directed toward low-value care. Insurers and government agencies are increasingly looking to maximize health value. Cost-effective analyses (CEA) is a complex valuation that grades health outcomes and economic benefits of a specific aspect of clinical care over a particular time horizon. In the US, therapies are generally considered cost-effective at ceilings between $50,000 - $150,000 per QALY. Critical components of CEA include model development to accurately represent clinical decisions and outcomes, evidence-based inputs, appropriate sensitivity analyses, and clarity in selecting the target population, perspective, comparators, time horizon, discount rate, and health outcomes. CEA can better inform trade-offs in patient care and add clarity in the translation of evidence to medical recommendations. Future research is likely to provide a more complete understanding of variation across population health state utilities for allergic conditions to more accurately reflect quality adjusted life years for patients with allergies. Conclusion Viewing healthcare options through an economic lens has become the standard of care across the United States and internationally, whether mandated through government agencies or third party payers. Decision analysis with cost-utility models can provide a useful perspective for both individual practice and public health.
Effect of Lower-Extremity Eccentric Training on Physical Function in Community-Dwelling Older Adults

Aims: The purpose of this study was to observe the effects of eccentric endurance training (ET) on physical function in community-dwelling older adults.Methods: Participants were randomly assigned ...
The Role of Right Ventricular Strain in Women and Men Following Left Ventricular Assist Device Implantation

Background Women and men have different perioperative hemodynamics, adverse event rates, and pump thrombosis-related mortality following left ventricular assist device (LVAD) implantation. However, gender differences in the subsequent development of right ventricular (RV) failure are not well defined. We evaluated the impact of gender on RV failure following LVAD implantation by speckle-tracking analysis of pre- and postoperative echocardiograms (echo). Methods Pre- and post-operative clinical, echo, and hemodynamic parameters were recorded in patients receiving LVADs from 2008-2018. Retrospectively, a subgroup of 74 women and 74 men were propensity score-matched 1:1 and chi square, t-tests, nonparametric tests, regression analysis, and Kaplan-Meier analysis were used to compare event rates. RV free-wall longitudinal strain (RV-FLS) and RV Fractional Area Change (RV-FAC) were calculated retrospectively using speckle-tracking, Tomtec Arena. All echo and RV strain measurements were blinded to gender outcomes. Results Preoperative hemodynamic parameters were not different between the two groups. However, women were more likely to have non-ischemic cardiomyopathy (81% vs 65%; p Conclusions RV strain analysis tracks standard hemodynamic and echo parameters and does not add to the assessment of RV function in women and men undergoing LVAD implantation.
Infection and Spondyloarthritis

The relationship between microbes and joints has been recognized since antiquity and remains to be fully elucidated. During the past few decades, however, significant advances have occurred in the diagnosis, pathogenesis, and therapeutic management of infection-related arthritides, especially in spondyloarthritis (SpA). The following chapter will present an overview of the potential role of microorganisms in the pathogenesis of spondyloarthritis including the clinical spectrum of reactive arthritis (ReA) to ankylosing spondylitis.
Tumors of the Salivary Gland

Recent advances in the diagnosis, differential diagnostics, and salient features of clinical relevance are concisely presented in this chapter. The role of fine needle aspiration and the limitations of this procedure in presurgical management of patients with these tumors are emphasized in communicating findings to clinicians. Similarly, the utilization of lineage-associated markers in the diagnosis and differential diagnosis of salivary and non-salivary tumors is tailored to emphasize context association. In this chapter, verified and consistent molecular and genetic findings are presented for familiarity and for their potential clinical and therapeutic implications. Emphasis on the future integration of these findings in current diagnosis and management remains to be validated.
Outpatient traffic analysis and management study of the hospital

Objective To investigate the pattern of outpatients traffic,orchestra service resources,and optimize service provision,for a harmonized outpatient service.Methods A baseline survey was made at the outpatient department in 30 days(six hours per day,7:00-11:00,and 13:00-15:00).On such basis,data of the hospital's HIS system within the last five years were called into play for statistics analysis and simulation test,for the purpose of shift scheduling and resources allocation optimization.Results This study discovered each January-February as the valley of clinic visits and each July-August as the peak.52-week data analysis of a year found that the days of daily registrations between 4000-5000 are up to 163 days,those over 5000 are up to 86 days,of which Mondays with over 5000 registrations are up to 35 days.Each Monday is found to be a peak of outpatient visits,with significant drop during Saturdays and Sundays; daily registrations peak between 7:00-10:00 in the morning,while the traffic rises again during 13:00-14:00 in the afternoon,yet up to 26 ％of the morning peak only.Conclusion Statistics analysis of the outpatient service and emergency service at the outpatient department can help identify their patterns of operations,for effective improvement of service provision,alleviation of peak hour workload,shorten patient waiting time and better patient satisfaction. Key words: Outpatients traffic; Patient visit pattern; Resources allocation; Optimal service
Pay gap between foreign-born and native-born doctors in the United States

Foreign-born doctors are an integral part of the U.S. labour market for doctors. About 29% of physicians, 24% of dentists, 16% of optometrists and 11% of podiatrists are not born in the United Stat...
Standing Up to Colonial Power: The Lives of Henry Roe and Elizabeth Bender Cloud

Review of: Standing Up to Colonial Power: The Lives of Henry Roe and Elizabeth Bender Cloud, by Renya K. Ramirez.
Functional characterization of ATF1, GREM2 AND WNT10B variants associated with tooth agenesis.

OBJECTIVE To determine the functional effects of ATF1, WNT10B and GREM2 gene variants identified in individuals with tooth agenesis (TA). SETTINGS AND SAMPLE POPULATION Stem cells from human exfoliated deciduous teeth (SHED) were used as an in vitro model system to test the effect of TA-associated variants. MATERIALS AND METHODS Plasmid constructs containing reference and mutant alleles for ATF1 rs11169552, WNT10B rs833843 and GREM2 rs1414655 variants were transfected into SHED for functional characterization of variants. Allele-specific changes in gene transcription activity, protein expression, cell migration and proliferation, and expression of additional tooth development genes (MSX1, PAX9 and AXIN2) were evaluated. Data analyses were performed using Student's t-test. P-values ≤ .05 were considered statistically significant. RESULTS Mutant variants resulted in significantly decreased transcriptional activity of respective genes (P < 0.05), although no changes in protein localization were noted. Expression of MSX1 was significantly decreased in ATF1- and GREM2-mutant cells, whereas PAX9 or AXIN2 mRNA expression was not significantly altered. Mutant WNT10B had no significant effect on the expression of additional TA genes. ATF1- and GREM2-mutant cells presented increased cell migration. Cell proliferation was also affected with all three mutant alleles. CONCLUSIONS Our results demonstrate that ATF1, WNT10B and GREM2 mutant alleles have modulatory effects on gene/protein function that may contribute to TA.
To PICC or not to PICC? A cross-sectional survey of vascular access practices in the ICU.

Abstract Purpose Vascular access patterns in the intensive care unit (ICU) have shifted from non-tunneled central venous catheters (CVCs) towards peripherally inserted central catheters (PICCs). We evaluated perceptions of critical care practitioners regarding these devices and variation in evidence-based practice. Materials A 35-question survey on ICU vascular access was deployed in 13 Michigan hospitals. Descriptive statistics summarized responses. Differences in utilization, perceptions and evidence-based practices between PICCs and CVCs, by participant and site-level characteristics, were assessed. Results 314 of 621 eligible providers responded to the survey (response rate 51%). 15% of providers reported not routinely using ultrasound when placing CVCs. Respondents whom were trainees, from larger hospitals, and from closed ICUs were more likely to use ultrasound (p Conclusion Variation in guideline-based vascular access practices exists in the ICU. Defined local protocols may improve guideline adherence. Studies evaluating vascular access decisions and patient safety in the ICU appear necessary.
Regression model for structural health monitoring of a lab scaled bridge

The interest in observation of the dynamic behavior of bridges have been increasing in the recent years. The movement of bridge deck plays a significant role in the safety of bridges. In this project work, a direct and indirect sensor mounted on the bridge structure and on the passing vehicle are used for structural health monitoring. The overall study has been implemented based on six reliable approaches, including Gradient Boosting regression, Random Forest Regression, Ridge Regression, Support Vector Regression, Elastic Net Regression, XGBoost Regression and Support Vector Regression to get accurate results of prediction for structural health condition. For each of these regression models, the following performance evaluations are obtained: Mean Square Error (MSE), Root Mean Square Error (RMSE) and Rsquared. After obtaining all performance evaluations, the comparison of each of these metrics are done for all the six regressors. Finally, by using a Voting Regression, these six regression models are combined and used to train the entire dataset and predict on the test set. By using voting regression an ensemble model is proposed for this experiment.
The Portrayal of Characters with Dyslexia in Children’s Picture Books

Children’s literature can be a useful tool to share the experiences of students with disabilities. Given the increased focus on dyslexia legislation in schools across the United States, it is important to examine how characters with reading differences, specifically dyslexia, are portrayed in picture books and the role these artifacts play in equitable pedagogical practices. We conducted a critical content analysis, focusing on characters with dyslexia in picture books and the literacy opportunities, barriers, and consequences. Findings show an imbalance in representation regarding race, ethnicity, and geographic location. While some picture books portray characters with self-advocacy and agency, others perpetuate stereotypical “blueprints” for characters with dyslexia with limited children’s school experiences, classroom interactions, and peer exchanges. We conclude that characters with dyslexia should resemble people from the real world, embodying complexity just as they would outside their storied lives. Findings and implications for practice are discussed.
Enacting Spiritual Activism to Develop a Sense of Belonging: Latina Community College Students Choosing and Persisting in STEM

Guided by the theoretical frameworks of sense of belonging and spiritual activism, this study examines the experiences of first-generation Latina community college students who navigated the choice...
Improving Outcomes of Mothers With Opioid Use Disorder Using a Community Collaborative Model.

Context:Increasing rates of Opioid Use Disorder among pregnant women are a significant public health issue. Care for these women is fragmented, and multiple barriers to care have been identified. P...
The MPI Message-Passing Interface Standard: Overview and Status

MPI (Message-Passing Inteface) has been developed over the last two years as a standard message-passing interface specification. This paper summarizes what MPI is, describes recent activities, particularly MPI implementation activities, and supplies sources for further information about MPI.
DESIGN AND DEVELOPMENT OF NOISE SUPPRESSION SYSTEM FOR DOMESTIC GENERATORS

Increase in demand for standby power sources and disruption in power supply has increased the use of generators manifold for domestic and industrial consumers leading to objections on their use concerning noise pollution. The work presented here aims to focus on how generator set noise is propagated, controlled and reduced to a limit as defined by domestic laws. The presented work is in fact a feasibility of a simple and effective design of an acoustic enclosure for portable generators aims at reducing the radiated noise. This effort is a multi-disciplinary work that comprises acoustics, heat transfer and material science. Heat generation and requirement of cooling air leads to a heat transfer model with internal forced convection. The design is a balance of noise control and thermal management. Noise generating areas have been identified and conventional passive noise control techniques have been used to control and reduce the noise. Acoustic barriers and insulation are used to control the noise propagation at its transmission path. In the conclusion comparison and results of noise are plotted using sound measuring techniques and devices as well as the thermal profiles of cylinder head are compared with and without canopy.
Family Planning Programs: Feminist Perspectives

Since the 1960s, governments and private organizations implemented family planning programs, largely driven by fears of rapid population growth. By the 1990s, the rationale for these programs shifted to the human right to autonomy in sexuality and reproduction. With the 20th anniversary of the United Nations International Conference on Population and Development Programme of Action approaching, this article examines the feminist critique of population programs that led to this historic shift. It examines gaps that remain in the implementation of the Programme of Action, and emerging issues – including youth sexual rights – that feminists are prioritizing as key areas for population and development policies and programs.
Therapeutic Alteration of Insulin-Dependent Diabetes Mellitus Progression by T Cell Tolerance to Glutamic Acid Decarboxylase 65 Peptides In Vitro and In Vivo

We have reported previously that nonobese diabetic (NOD) fetal pancreas organ cultures lose the ability to produce insulin when maintained in contact with NOD fetal thymus organ cultures (FTOC). Initial studies indicated that exposure to glutamic acid decarboxylase (GAD65) peptides in utero resulted in delay or transient protection from insulin-dependent diabetes mellitus (IDDM) in NOD mice. We also found that exposure of young adult NOD mice to the same peptides could result in acceleration of the disease. To more closely examine the effects of early and late exposure to diabetogenic Ags on T cells, we applied peptides derived from GAD65 (GAD AA 246-266, 509-528, and 524-543), to our "in vitro IDDM" (ivIDDM) model. T cells derived from NOD FTOC primed during the latter stages of organ culture, when mature T cell phenotypes are present, had the ability to proliferate to GAD peptides. ivIDDM was exacerbated under these conditions, suggesting that GAD responsiveness correlates with the ivIDDM phenotype, and parallels the acceleration of IDDM we had seen in young adult NOD mice. When GAD peptides were present during the initiation of FTOC, GAD proliferative responses were inhibited, and ivIDDM was reduced. This result suggests that tolerance to GAD peptides may reduce the production of diabetogenic T cells or their capacity to respond, as suggested by the in utero therapies studied in NOD mice.
On thick description and narrative inquiry in music education

The use of `thick description' is evident in various research traditions in the social sciences. Important in American anthropology in the latter half of the 20thcentury, it has been imported somewhat uncritically into educational research. In our time, it is also seen as a means whereby scholars and scholar-practitioners can generate new descriptive knowledge and recover knowledge that has been lost or fallen into obscurity. My present task is to notice the philosophical roots of thick description in the work of Gilbert Ryle and its subsequent use by the American anthropologist, Clifford Geertz. I also note Adam Kuper's critique of Geertz's anthropological use of the term. And after `rescuing' aspects of thick description, I sketch implications for narrative inquiry in music education.