cssi/SciSciGPT-SciSciNet huggingface dataset:
Epidemiology of vascular disease in renal failure.

Cardiovascular disease (CVD) is the leading cause of death in the general population and a major cause of morbidity and mortality chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients. The high prevalence of CVD in incident dialysis populations suggests that CVD begins during or before the stage of chronic renal insufficiency. While traditional risk factors observed in the general population may play a role in the progression of CVD in CKD and ESRD patients, the presence of several nontraditional factors related to the extent of uremia seems to be the more significant feature of CVD in this patient population. Recently, there have been significant advances in our understanding of how inflammation contributes to the pathogenesis of atherosclerosis and myocardial infarction. The fact that chronic inflammation and CVD are highly prevalent in ESRD patients, it is probable that chronic inflammation may be a causative factor for accelerated atherosclerosis observed in CKD and ESRD patients. Given the extent of the problem, efforts to lower the mortality rate among ESRD patients will require new approaches to reduce and/or prevent cardiovascular morbidity and mortality.
A Minimalist Approach to Null Subjects and Objects in Second Language Acquisition.

Studies of the second language acquisition of pronominal arguments have observed that:(1) L1 speakers of null subject languages of the Spanish type drop more subjects in their second language (L2) ...
Comparison of direct and downconverted digitization in GPS receiver front end designs

This paper compares two front end designs of a global positioning system (GPS) receiver. The first approach is the direct digitization of the input signal and the second approach is to downconvert the input signal to an intermediate frequency (IF) then digitize it. Theoretically, these two methods should produce similar results and our experimental data support this argument.
Running Classroom Experiments in a Large Enrollment Economics Course

During the last two decades we have seen the emergence of numerous experimental designs especially suited for teaching in economics. Nevertheless, for the most part, most of these experiments are suited only for classes with small enrollment. This is unfortunate for two reasons. First, most students in college universities take their first (and sometimes more advanced) economics courses in a classroom with at least 100 students or more. Second, large enrollment classes create a set of dynamics impossible to replicate in their much smaller counterparts. While some have suggested ways of adjusting experiments for large classes, for the most part these adjustments always involve engaging only a small portion of the large class while the rest of the students are merely passive observers. In this article I will document my experience in administering one popular experiment, the double-auction, in a large enrollment class at the University of Illinois at Urbana-Champaign (UIUC). Since it is designed to be used in a large class where all students participate, this version of the experiment requires very little in terms of materials, technology, and data collection. This case study shows that by making certain adjustments to this popular experiment it is possible to create an activity that can be applied to any class size. Furthermore, by creating some dynamics impossible to replicate in the small classroom, the experiment in a large class has the potential of presenting a new pedagogical experience for students and instructors.
Photonic Crystal Device Optimization Without Increasing Fabrication Tolerances: A Mode Demultiplexer Design

We present a powerful photonic crystal device optimization technique that generates robust designs without requiring precision tuning of device parameters. We optimize the performance of a compact (8.2x13.3um) waveguide mode demux with the method.
Prospective study of a proactive palliative care rounding intervention in a medical ICU

To evaluate the effects of a palliative care intervention on clinical and family outcomes, and palliative care processes. Prospective, before-and-after interventional study enrolling patients with high risk of mortality, morbidity, or unmet palliative care needs in a 24-bed academic intensive care unit (ICU). The intervention involved a palliative care clinician interacting with the ICU physicians on daily rounds for high-risk patients. One hundred patients were enrolled in the usual care phase, and 103 patients were enrolled during the intervention phase. The adjusted likelihood of a family meeting in ICU was 63 % higher (RR 1.63, 95 % CI 1.14–2.07, p = 0.01), and time to family meeting was 41 % shorter (95 % CI 52–28 % shorter, p < 0.001). Adjusted ICU length of stay (LOS) was not significantly different between the two groups (6 % shorter, 95 % CI 16 % shorter to 4 % longer, p = 0.22). Among those who died in the hospital, ICU LOS was 19 % shorter in the intervention (95 % CI 33–1% shorter, p = 0.043). Adjusted hospital LOS was 26 % shorter (95 % CI 31–20 % shorter, p < 0.001) with the intervention. Post-traumatic stress disorder (PTSD) symptoms were present in 9.1 % of family respondents during the intervention versus 20.7 % prior to the intervention (p = 0.09). Mortality, family depressive symptoms, family satisfaction and quality of death and dying did not significantly differ between groups. Proactive palliative care involvement on ICU rounds for high-risk patients was associated with more and earlier ICU family meetings and shorter hospital LOS. We did not identify differences in family satisfaction, family psychological symptoms, or family-rated quality of dying, but had limited power to detect such differences.
Abstract 13078: Model-based Reexpression of Vortex Formation Time Differentiates Between Pseudonormal vs. Normal Left Ventricular Echocardiographic Filling Patterns

Introduction: The column of blood aspirated into the LV during early, rapid filling (Doppler E-wave) forms an expanding toroidal vortex ring and facilitates leaflet tip coaptation during diastasis. Vortex formation time (VFT) is the standard dimensionless index used for quantification of vortex ring growth whose definition is VFT standard = (E-wave velocity time integral (EVTI) [cm])/(mitral orifice diameter [cm]). A previously validated expression, { VFT model-based = (EVTI)/ (effective mitral orifice diameter)} incorporates left heart ‘constant-volume pump’ physiology and reveals VFT’s explicit E/E’ dependence. Previously, VFT standard has been shown to differentiate between normal vs. impaired filling based on E-wave differences. Here, we show that VFT model-based can differentiate between pseudonormal (PN) vs. normal (NL) E-wave patterns. Method: Thirteen age-matched NL and 12 PN subjects (defined as subjects with E/E’>8 and E’ peak VFT standard and 2) VFT model-based using the above stated definitions and previously validated methods. Result: VFT standard did not differentiate between groups [NL (3.58±1.06) vs. PN (4.18±0.79), p = 0.13] whereas VFT model-based did [NL (3.15±1.28) vs. PN (4.75±1.35), p=0.006 (Fig. 1)]. Conclusion: Compared to VFT standard , VFT model-based is sensitive to the physiological changes associated with pseudonormalization. Since VFT model-based explicitly incorporates longitudinal chamber (E’) motion, VFT as a diastolic function index can now be used for analysis of pseudonormal filling patterns.
Transcending the divide between history and memory: Szymon Datner's practical Holocaust historiography in the early post-war period

ABSTRACTThis article deals with Szymon Datner's narratives of the Holocaust in Bialystok and its surroundings, which he produced in the aftermath of liberation from German occupation (from 1944 onwards). Datner (1902–89) survived the Bialystok ghetto from where he escaped in June 1943 to become a partisan fighter. His family was murdered by the Germans. In his capacity as chairman of the Bialystok Jewish Committee and as a member of the Jewish Historical Commission at the Committee, he played a vital role in recording, documenting, interpreting, and commemorating the murder of the Jews in Bialystok and its surroundings. This article analyzes the characteristic features of some of his early historical as well as artistic writings in Polish and Yiddish. It argues for a new way of appreciating the effort to write the history of an event in its immediate aftermath (or even while it is still taking place), a way of reading these kinds of sources as a kind of hybrid, involving both memory and the ethical impera...
Simultaneous tests for homogeneity of two zero-inflated (beta) populations

ABSTRACTMotivated by an example in marine science, we use Fisher’s method to combine independent likelihood ratio tests (LRTs) and asymptotic independent score tests to assess the equivalence of two zero-inflated Beta populations (mixture distributions with three parameters). For each test, test statistics for the three individual parameters are combined into a single statistic to address the overall difference between the two populations. We also develop non parametric and semiparametric permutation-based tests for simultaneously comparing two or three features of unknown populations. Simulations show that the likelihood-based tests perform well for large sample sizes and that the statistics based on combining LRT statistics outperforms the ones based on combining score test statistics. The permutation-based tests have overall better performance in terms of both power and type I error rate. Our methods are easy to implement and computationally efficient, and can be expanded to more than two populations a...
Firefighters' cardiovascular health and fitness: An observation of adaptations that occur during firefighter training academies.

BACKGROUND Firefighters' cardiovascular fitness remains a foremost concern among fire departments and organizations, yet very little research has been conducted to examine the cardiovascular fitness adaptations that occur during firefighter training academies. OBJECTIVE To describe the cardiovascular adaptations observed among firefighter recruits during firefighter training academies using measures of estimated maximal oxygen uptake (VO2max) and heart rate recovery (ΔHR). METHODS Firefighter recruits (n = 41) enrolled in a 16-week firefighter training academy completed a 5-minute step test during the first, eighth, and sixteenth week of training. Repeated measures analysis of variance (RM ANOVA) calculations were conducted to determine changes in estimated VO2max and ΔHR. RESULTS Results of the RM ANOVA calculations revealed that mean estimated VO2max and mean ΔHR differed significantly between time points: F(2, 80) = 75.525, p < 0.001, and F(2, 80) = 4.368, p = 0.016, respectively. No significant changes were observed in mean estimated VO2max and mean ΔHR beyond the eighth week of training. No significant relationship was identified between estimated VO2max and ΔHR. CONCLUSIONS Although firefighter recruits' estimated VO2max and ΔHR change significantly over the course of the firefighter training academy, the measures may not be equal predictors of cardiovascular fitness.
College Women’s Perceptions of and Inclination to Use Campus Sexual Assault Resources Comparing the Views of Students With and Without Sexual Victimization Histories

The purpose of this study is to explore whether college women’s perceptions of and inclination to use campus sexual assault resources vary as a function of their sexual victimization histories. Fir...
Problem Solving: The Process:

A technique for the characterization of problem-solving processes is presented along with criteria for their evaluation according to norms established logically and statistically.
Health Care Reform From the View of a Geriatrician

In an ideal world, all citizens would receive high-quality health care, all services which are appropriate and necessary, in the setting that can best meet the patients' needs and preferences. The frail, dependent, chronically ill person has been considered an outlier by third party payment systems, including Medicare, the health care system designed for the elderly. Physician payment systems have penalized those who care for the frail, resulting in an inadequate medical workforce to care for the elderly. Medicare and state-financed long-term care systems, by attempting to limit expenditures of public funds on long-term care, have become biased toward institutional care. Although the frail and disabled represent a minority (approximately 12%) of those aged 65 or older, their numbers are large and growing. The health care system of today and the system proposed for tomorrow by the Clinton Administration is not prepared to care for large numbers of people with chronic, disabling illness. Only when the health care system or new health alliances share responsibility for all care provided to every citizen will the looming problems of large numbers of persons with chronic illness and functional dependency be faced. Care must be driven by patient needs and preferences, not by reimbursement regulations and financial incentives. The Clinton plan institutionalizes the segregation of chronic long-term care from hospital and outpatient care. Responsibility for these services is relegated to states. This political compromise, as disappointing as it may be to geriatricians, may offer opportunity for experimentation. Fifty new state-regulated systems may serve as health services experiments.(ABSTRACT TRUNCATED AT 250 WORDS)
Characterization of Eu- and Y-polytantalate Films Deposited by RF Diode Sputtering

Using radio frequency (RF) diode sputtering of sintered stoichiometric (Eu,Y) 2 O 3 :7Ta 2 O5 ceramic targets, thin films (0.2–0.6 m) of Eu- and Y-polytantalates, and their solid solution Eu x Y 1-x Ta7O19 were deposited on fused silica, Si (100) and sapphire (001) substrates under various sputtering conditions. As-grown films were amorphous, and were crystallized by post-annealing in oxygen at 900 to 1000 °C. The influences of deposition gases (Ar and O 2 -partial pressure) substrate material, deposition time, substrate temperature, and post-annealing time and temperature on the structural, morphological and photo-luminescence (PL) properties of Eu 3+ -ions in the films have been studied and compared to properties of sintered (Eu,Y)Ta 7 O 19 ceramic and EuTa 7 O 19 single crystals.
Well-to-Wheels Greenhouse Gas Emissions Analysis of High-Octane Fuels with Various Market Shares and Ethanol Blending Levels

In this study, we evaluated the impacts of producing HOF with a RON of 100, using a range of ethanol blending levels (E10, E25, and E40), vehicle efficiency gains, and HOF market penetration scenarios (3.4% to 70%), on WTW petroleum use and GHG emissions. In particular, we conducted LP modeling of petroleum refineries to examine the impacts of different HOF production scenarios on petroleum refining energy use and GHG emissions. We compared two cases of HOF vehicle fuel economy gains of 5% and 10% in terms of MPGGE to baseline regular gasoline vehicles. We incorporated three key factors in GREET — (1) refining energy intensities of gasoline components for the various ethanol blending options and market shares, (2) vehicle efficiency gains, and (3) upstream energy use and emissions associated with the production of different crude types and ethanol — to compare the WTW GHG emissions of various HOF/vehicle scenarios with the business-as-usual baseline regular gasoline (87 AKI E10) pathway.
Subclinical infection investigation and its risk factors analysis of hand-footmouth disease on healthy kindergarten children

Objective To understand the subclinical infection condition and its risk factors of the hand-foot-mouth disease among healthy kindergarten children in Longgang district,Shenzhen.Methods Total 118 healthy children from 2 kindergartens were selected for questionnaire and anal swab sample collection for the detection of viruses.Results Among the 118 anal swab samples,28 were positive for enteroviruses multipurpose detection using RT-PCR,with a subclinical infection rate of 23.73%.The subclinical infection rates of EV71 and the other enteric viruses(except for EV71 and CoxA16) among the healthy children were 5.93% and 17.80%,respectively.No CoxA16 and combined infection was detected among all the anal swab samples.Logistic regression analysis indicated that there were hand-foot-mouth diseases outbreaks in the class during the last two weeks(OR=11.836).Other family member under the age of 14 years(OR=9.016) had consulted the doctor during the last two weeks(OR =29.777) was the risk factor for subclinical infection of the total enterovirus,EV71 and the other enterovirus.The hand washing habits more than 2 times a day was a protective factor for the subclinical infection of healthy children for the total enterovirus(OR=0.132) and the other enterovirus(OR=0.255).Conclusion The enterovirus subclinical infection is common among the healthy kindergarten children,and the condition of the subclinical infection is affected by a variety of factors such as the living environment and the health habits of the healthy kindergarten children.More attentions should be paid on the improvement of the children′s health habits such as hands washing and toys disinfection so as to reduce the subclinical infection of the hand-foot-mouth disease.
Shorter dosing interval of opiate solution shortens hospital stay for methadone babies.

BACKGROUND AND OBJECTIVES Methadone maintenance is the standard of care for pregnant opiate addicts. However, withdrawal of an infant from methadone after birth often results in a lengthy hospital stay. This study identified potentially modifiable factors that are associated with the length of hospital stay of infants of mothers on methadone. METHODS This study used a retrospective case series of patients from a university hospital in Texas. Eligible participants included 41 neonates born between January 1991 and December 1996 to mothers taking methadone at time of delivery. Charts were reviewed for factors relating to administration of opiates to the newborn, and the length of the hospital stay was recorded for each infant. Bivariate and multiple regression analyses were performed using length of hospital stay as the outcome measure. RESULTS Higher peak dose of tincture of opiate solution (TOS) and longer dosing interval were found to be related to longer length of hospital stay. These variables explained 23% of the variation in length of stay. CONCLUSIONS Lower peak doses of TOS and shorter dosing intervals may be associated with shorter hospital stays for infants with neonatal abstinence syndrome secondary to maternal methadone treatment.
SPECT: Accreditation and Certification

This chapter provides the necessary information and tools for accreditation as part of the quality improvement continuum. The importance of accreditation will be emphasized. Each of the pathways for laboratory accreditation for SPECT imaging will be examined as well as the differences between the pathways. These pathways include the American College of Radiology, the Intersocietal Accreditation Commission, and the Joint Commission. Pathways to physician certification will also be discussed. The importance of both accreditation and certification to laboratory quality will be discussed.
New Wine in Old Bottles? An Essay Review

Opportunity, Responsibility and Security: A Consensus Plan for Reducing Poverty and Restoring the American Dream. Washington, DC: The Brookings Institution. 88 pages. No price. http://www.brookings.edu/research/reports2/2015/12/aei-brookings-poverty-and-opportunity. AEI/Brookings Working Group on Poverty and Opportunity. 2015. With financial support from the American Enterprise Institute, the Annie E. Casey Foundation, and the Ford Foundation, 15 credentialed poverty specialists worked together for 14 months in an environment of “open-mindedness” and “civility” and concluded that working together to reduce poverty rested on three interconnected values that all Americans share: opportunity, responsibility, and security.
Ionic Liquid versus Li(+) Aqueous Solutions: Water Dynamics near Bistriflimide Anions.

The ultrafast dynamics of concentrated aqueous solutions of the salt lithium bistriflimide and ionic liquid (IL) 1-ethyl-3-methylimidazolium bistriflimide was studied using two-dimensional infrared (2D IR) vibrational echo and polarization-selective IR pump–probe techniques to monitor water’s hydroxyl stretch. Two distinct populations of hydroxyl groups, with differing vibrational lifetimes, are detected in solution: those engaged in hydrogen bonding with other water molecules and those engaged in hydrogen bonding with the bistriflimide anion. Water molecules with the same hydrogen bond partner exhibit similar vibrational lifetimes in the two solutions. The reorientation dynamics of the anion-associated waters is also similar in form in the two solutions, showing a restricted wobbling-in-a-cone motion followed by a slower diffusive orientational randomization. However, the wobbling motions are much more angularly restricted in the IL solution. Spectral diffusion dynamics, which tracks the structural fluct...
Observations of Stress and Health: A Micro Investigation of Perception among University Students

This study analyzed how university students perceived their level of stress, as well as their overall health. Using a survey instrument, the majority of students rated their stress level as "average." The primary causes of stress were funding, job security, responsibility, time, and work load. Almost all of the respondents had complaints of illness over the previous six months, however the majority of students did not take time off for those illnesses. Illness related symptoms most commonly reported were headache, sleep disturbance, flu, and allergies. Only a very small percentage had seen a physician during the previous six months and very few noted they were taking prescription medication. Over 90% rated their overall health as either average or good.
The integration of access control levels based on SDN

Systems and networks include several inputs and outputs from which they are accessed. Access controls exist to manage authentication and access controls through those inputs and outputs. One of the significant problems in this scope is the difficulty to have a global consistent system or network level access control. Such global centralised access control is needed to make sure that access control decisions taken by different applications at different levels are consistent. In this paper, we propose an SDN-based access control to approach this problem. Different access control methods are proposed to handle user and flow level access information. Access tables in those methods are initiated by network administrators. Concrete rules in those access tables can change dynamically based on network activities. We believe that ultimately all access control systems are going to converge in this direction.
Decline in Sexual Functioning Over a 3-Year Period after Hematopoietic Cell Transplantation (HCT): Gender-Specific Impact of Total Body Irradiation (TBI) and Chronic Graft-Versus-Host Disease (cGvHD)

Sexual dysfunction is a multidimensional problem caused by both physiologic and psychosocial factors. Yet little is known about the longitudinal trends of sexual functioning in HCT survivors, or the clinical or psychosocial factors associated with decline. Using a longitudinal study design, we administered the Derogatis Interview for Sexual Functioning (DISF-SR), the Global Sexual Satisfaction Index (GSSI), and the City of Hope-QOL instrument at 5 time points to a large cohort of patients undergoing HCT at City of Hope (COH): prior to HCT, at 6m, 1y-, 2y-, and 3y-post-HCT. DISF-SR assessed 5 domains of sexual functioning (Cognition/Fantasy, Arousal, Behavior/Experiences, Orgasm, and Drive/Relationship), and a Total score. GSSI elicited patients’ subjective appraisal of sexual satisfaction. The COH-QOL instrument was used to obtain self-reported levels of anxiety, distress, depression, pain, physical strength, and sleep changes, which were converted to composite scores of mental and physical stress. Long-term trends of sexual functions were estimated using the Generalized Estimating Equation. We examined the effects of sociodemographic factors, primary diagnosis, HCT conditioning regimens, disease status at HCT, presence of cGvHD, and composite mental and physical stress levels on the longitudinal trends of DISF-SR, the Total score, and GSSI. The cohort included 312 adults (median age at HCT 48y; 56% males) undergoing autologous (n=175) or allogeneic (n=137) HCT for hematologic malignancies or severe aplastic anemia; 144 patients completed the 3y sexual survey (participation rate at 3 years=75%). GSSI (general sexual satisfaction) declined significantly after HCT (p=0.001) for both men and women, and remained depressed over the 3-y study period, with 40% reporting poor or worse sexual satisfaction level at 3y. There were no significant differences between men and women in terms of general sexual satisfaction level. However, the degree of sexual dysfunction as measured by DISF-SR was worse in women than in men for all domains, and for Total score (p
Do Americans Really Save Too Little and Should We Nudge Them to Save More? The Ethics of Nudging Retirement Savings

The contention that consumers systematically “undersave” for retirement is a frequent example provided by adherents to behavioral economics and behavioral law and economics to purportedly illustrate their theories. Although frequently asserted, the claim that people systematically undersave is rarely assessed empirically. This article, written for the Georgetown Institute for the Study of Markets and Ethics Symposium on “The Ethics of Nudging,” examines available data on how many people fail to save and the reasons why they do not. According to available evidence, the overwhelming number of households saves enough or more than they need for retirement; only a small minority does not seem to save enough. Those who do not save for retirement lack the money to do so or allocate available resources to paying down consumer and student loan debt. Behavioral economics theories explain little of the observed patterns of saving or non-saving behavior. Moreover, behavioral economics itself suggests that many people probably oversave for retirement and makes no effort to reconcile these offsetting biases. More fundamental, once it is recognized that there is an opportunity cost to saving more—one must consume less today, borrow more, or work more—the theoretical validity of the claim that people undersave because of behavioral biases is suspect. Given the inherently subjective nature of opportunity cost, a central planner cannot be confident that he can make people better off by influencing their consumption expenditures across time than he could by shifting consumption expenditures across different goods and services today. It is concluded that there is little reason to believe that people would be made better off by nudging them to save more for retirement.
Abstract WP383: An Economic Model of Improved Acute Stroke Care in the Management of Acute Ischemic Stroke From A State Medicaid Perspective

Background: Stroke is a leading cause of long-term disability in the United States. Approximately one in four stroke survivors is admitted to a nursing home, accounting for a significant portion of Medicaid spending on stroke. Objective: To assess the impact of increasing access to primary stroke centers (PSCs) and implementing an emergency medical services (EMS) system on disability and Medicaid spending on nursing homes for ten geographically representative states. Methods: An economic model was developed to estimate potential reductions in stroke-related disability and corresponding reductions in Medicaid spending on nursing homes among Medicaid enrollees with acute ischemic stroke (AIS), due to improved stroke care infrastructure. The model assessed the increased use of intravenous (IV) thrombolysis as a result of a higher proportion of AIS treated in PSCs, or as a result of integrating an EMS system with PSCs. Based on published literature, more patients received IV thrombolysis in PSCs vs. non-PSCs (6.5 vs. 0.9%) and PSCs with an EMS routing protocol vs local services (10.5 vs. 2.5%). State-specific model inputs included the incidence of first-ever AIS in Medicaid enrollees, nursing home costs, and Medicaid spending on stroke-related care. Results: A 20% absolute increase in the proportion of AIS patients treated at PSCs will lead to 111 to 2004 more patients receiving IV thrombolysis; 9 to 160 fewer patients with disability; and a reduction in Medicaid nursing home spending of $299,442 to $5.6 million per year across the ten states analyzed (Table). The integration of an EMS system with PSCs will lead to 791 to 14,314 more patients receiving IV thrombolysis; 63 to 1145 fewer patients with disability; and a reduction in Medicaid nursing home spending of $2.1 to $40.0 million per year across the ten states (Table). Conclusions: States may achieve substantial savings through legislative policies that improve PSC access and integration of an EMS system with PSCs.
Quantifying the Lead Time Required for a Linear Trend to Emerge from Natural Climate Variability

AbstractThis study introduces a simple analytic expression for calculating the lead time required for a linear trend to emerge in a Gaussian first-order autoregressive process. The expression is derived from the standard error of the regression and is tested using the NCAR Community Earth System Model Large Ensemble of climate change simulations. It is shown to provide a robust estimate of the point in time when the forced signal of climate change has emerged from the natural variability of the climate system with a predetermined level of statistical confidence. The expression provides a novel analytic tool for estimating the time of emergence of anthropogenic climate change and its associated regional climate impacts from either observed or modeled estimates of natural variability and trends.
Systems Not Stabilizable by Continuous Feedback

Some systems cannot be globally asymptotically stabilized by smooth (or even continuous) feedback. This is not simply a lack of controllability. It might happen that, while every state can be steered to the origin by some control law, these control laws cannot be patched together in a continuous fashion to yield a globally defined stabilizing feedback. In this section we discuss how this situation can occur.
An examination of the perceived impact of a continuing interprofessional education experience on opiate prescribing practices

Chronic pain is increasingly recognized as a public health problem. We assessed the effectiveness of a multi-modal, interprofessional educational approach aimed at empowering healthcare professionals to make deliberative changes, especially in opiate prescribing practices. Education activities included enduring webcasts, regional interprofessional roundtable events, and state-level conference presentations within targeted Kentucky and West Virginia regions of the United States. Over 1,000 participants accessed the various activities. For the live events, the largest groups reached included nurses (38.1%), nurse practitioners (31.2%), and physicians (22.1%). In addition to our reach, higher levels of educational effectiveness were measured, specifically, learner's intentions to change practice patterns, confidence in meeting patient's needs, and knowledge of pain management guidelines. The majority of the conference (58%) and roundtable (69%) participants stated they intend to make a practice change in one or more areas of chronic pain patient management in post-event evaluation. Differences in pre- and post-activity responses on the measures of confidence and knowledge, with additional comparison to a control population who were not in attendance, were analyzed using non-parametric tests of significance. While neither activity produced significant changes in confidence from pre-activity, participants were more confident post-activity than their control group peers. There were significant changes in knowledge for both live event and webcast participants. Impactful chronic pain continuing the education that emphasizes collaborative care is greatly needed; these results show that the approaches taken here can impact learner's knowledge and confidence, and hold potential for creating change in how opioid prescribing is managed.
Race/ethnicity is an independent risk factor for autoimmune hepatitis among the San Francisco underserved.

Although autoimmune hepatitis (AIH) is more common in women and affects people of all races/ethnicities, there is currently limited information regarding the relationship between race/ethnicity and...
The use of radioactive isotopes to measure the transfer of materials in aquatic food chains

Radioisotopes have been misused extensively by ecologists in transfer studies within food chains. Unless it is known that no recycling of isotope has occurred during the experiment, the assumption of linear uptake when in fact the system is not linear, even over short periods, can lead to significant errors in the estimation of ingestion or feeding. If recycling occurs, at least a 3 or 4-compartment, hydraulic-type model is necessary to even approximate the complicated kinetics of isotopic transfer in a simple aquatic feeding experiment. In any event, it is essential to follow the uptake or loss of an isotope (change in specific activity) as a function of time in at least 1 compartment before deciding on an appropriate model. If experiments are designed so that the maximum number of rate processes are summed or integrated by the animal, the kinetics can be considerably simplified. If the food supply is uniformly labelled, the rate of change of tracer can be used to give a rate of ingestion (grazing). If the predator is labelled with a suitable isotope before starting the experiment, the rate of loss of its isotope burden under different experimental conditions can be used to determine respiration or excretion rates, turnover rates, ingestion, and the size and number of major compartments in the transfer system.
Dense Serpentine Implementation for PTI T -topology at 400MT/s

In this paper a routing alternative is presented using dense serpentine to reduce real estate in board and package routing design implementations. PTI interface is used as an example of a T-topology that requires length matching between branches. A comparison using standard straight routing versus dense serpentine is done to show that dense serpentine does not have a degradation impact on eye margins.
A Psychosocial Risk Model of Potentially Traumatic Events And Sexual Risk Behavior Among LGBTQ Individuals

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals face heightened risk of potentially traumatic events (PTEs) exposure, including hate crimes and childhood abuse. Past research demonstrates associations between PTEs exposure and sexual risk behavior; however, examining the indirect effect of PTEs on sexual risk behavior remains understudied among LGBTQ individuals. This study tested a path analysis model to inform interventions targeted to reduce sexual risk behavior, as conceptualized by condomless sex with casual partners without knowing the person's HIV or sexually transmitted infection (STI) status, among LGBTQ individuals with PTEs exposure. Participants completed an online one-time survey and included 207 LGBTQ adults who experienced at least one PTE during the past year. Indirect effect results indicated that PTEs exposure was related to sexual risk behavior through serial associations between shame, loneliness, and substance use. Direct effect estimates indicated that greater PTEs exposure was associated with greater shame, loneliness, substance use, and sexual risk behavior. Greater shame was associated with greater loneliness, which was associated with greater substance use. Also, greater substance use was associated with greater sexual risk behavior. This study adds to the burgeoning body of literature on the relationship between PTEs exposure and sexual risk behavior among LGBTQ individuals. Clinical and counseling interventions for LGBTQ individuals with PTEs exposure should work to address modifiable psychosocial risk factors associated with sexual risk behavior.
Phantom holes: optimised internal structural design for use with additive manufacturing, typical fused filament fabrication systems

It is understood that additive manufacturing (AM) allows the designer to control the exterior shape and internal structure for the design and fabrication of products. However, although AM allows for some internal structural control, how the designer controls that internal structure is limited to the options of the slicing software and the equipment. The designer does not have options within current slicer software to create customised shapes of concentrated material within the internal structure. Designers have to increase the infill throughout the entire object to address a limited area material failure zone. This paper introduces a methodology known as the phantom hole (PH) technique that will allow designers to create custom shaped, solid, internal structures within objects fabricated by many fused filament fabrication (FFF) machines. In initial shear and flexural testing, the PH technique resulted in a 39% improvement in specimen loading performance over specimens fabricated with higher infill percentages.
Structural Dynamics in Molecules Observed with Femtosecond X-Ray Pulses

In a recent publication in Nature Chemistry, Stankus et al. describe a new method to retrieve time-dependent molecular structures from X-ray diffraction patterns, capturing the dynamics in photoexcited N-methylmorpholine as it undergoes a structural transformation and revealing coherent vibrations after the molecule relaxes back to the electronic ground state.
Nonsmooth Optimal Value and Policy Functions in Mechanical Systems Subject to Unilateral Constraints

State-of-the-art approaches to optimal control use smooth approximations of value and policy functions and gradient-based algorithms for improving approximator parameters. Unfortunately, we show that value and policy functions that arise in optimal control of mechanical systems subject to unilateral constraints – i.e., the contact-rich dynamics of robot locomotion and manipulation – are generally nonsmooth due to the underlying dynamics exhibiting discontinuous or piecewise-differentiable trajectory outcomes. Simple mechanical systems are used to illustrate this result and the implications for optimal control of contact-rich robot dynamics.
Diabetic Myonecrosis: An Uncommon Complication of a Common Condition.

Introduction Diabetic myonecrosis is an uncommon complication of diabetes mellitus, most often occurring in patients with poorly controlled, insulin-dependent diabetes. Its etiology is poorly understood, with many suggesting microvascular occlusion to be a key factor resulting in necrosis of skeletal muscle. Case presentation A 28-year-old male with a history of poorly controlled type I diabetes mellitus and end-stage renal disease requiring dialysis presented to the emergency department with severe pain of the lower extremities bilaterally. Results Work-up included an x-ray, which demonstrated no acute fractures but extensive vascular calcification of the lower extremities, and Doppler ultrasonography, which showed no DVT. MRI demonstrated severe muscular edema with patchy, geographic areas of sparing, which, in conjunction with the patient's clinical presentation, allowed for a diagnosis of diabetic myonecrosis. He underwent conservative treatment, consisting of rest and pain management, leading to resolution of symptoms. Discussion Diabetic myonecrosis, although uncommon, can be easily diagnosed with a high degree of clinical suspicion. It typically presents in a patient with poorly controlled diabetes, and will commonly involve the proximal muscles of the lower extremity unilaterally, but may present bilaterally and involve the distal muscles, as demonstrated in this case. Diagnosis is made via MRI, and it is treated conservatively with pain management and rest. Most cases resolve with conservative management but recurrence is common. Learning points Diabetic myonecrosis is an uncommon complication of diabetes mellitus, most often occurring in patients with poorly controlled, insulin-dependent diabetes presenting with significant unilateral lower extremity pain, although bilateral presentation is also possible.A diagnosis of diabetic myonecrosis can be easily made with MRI, which demonstrates highly characteristic muscular edema with patchy areas of geographic sparing, but a high degree of clinical suspicion is necessary to reach a diagnosis.Recurrence of diabetic myonecrosis is common, and should be suspected in patients who have a history of this condition presenting with recurrent musculoskeletal pain, even if this pain is localized to a different muscle group.
9 – Examination of Witnesses

Publisher Summary This chapter focuses on the general rules regulating the qualification of witnesses and witness examination by the prosecution and the defense. The chapter covers the qualifications of the witnesses, the requirement of the oath or affirmation, separation of witnesses, direct and cross-examination of witnesses, and the process of witness impeachment and rehabilitation. Generally, to be eligible to testify, a witness must have a personal connection with the relevant occurrence, coupled with mental and physical faculties sufficient to observe the events at the time of their occurrence, and must be able to recollect and relate the events to the jury or court in a manner that renders the relevant testimony. Before the witness gives substantive information, he or she is required to state under oath or affirmation that he or she will testify truthfully. To prevent witnesses from being influenced by the testimony of other witnesses, the judge has the discretion to separate the witnesses during the trial so they are in the courtroom only when called upon to testify and cannot coordinate their testimony with other witnesses. When the witness has no present recollection of the events or has a deficient memory that does not allow the witness to testify properly and fully, concerning what occurred at the time, and the information has been preserved, the writing may be admissible. Where the witness remembers that he or she recorded the facts concerning the action, the writing or memorandum of past recollection is admitted when the proponent has laid a proper foundation.
SIRT7-mediated modulation of glutaminase 1 regulates TGF-β-induced pulmonary fibrosis

In the current work we show that the profibrotic actions of TGF-β are mediated, at least in part, through a metabolic maladaptation in glutamine metabolism and how the inhibition of glutaminase 1 (GLS1) reverses pulmonary fibrosis. GLS1 was found to be highly expressed in fibrotic vs normal lung fibroblasts and the expression of profibrotic targets, cell migration, and soft agar colony formation stimulated by TGF-β required GLS1 activity. Moreover, knockdown of SMAD2 or SMAD3 as well as inhibition of PI3K, mTORC2, and PDGFR abrogated the induction of GLS1 by TGF-β. We further demonstrated that the NAD-dependent protein deacetylase, SIRT7, and the FOXO4 transcription factor acted as endogenous brakes for GLS1 expression, which are inhibited by TGF-β. Lastly, administration of the GLS1 inhibitor CB-839 attenuated bleomycin-induced pulmonary fibrosis. Our study points to an exciting and unexplored connection between epigenetic and transcriptional processes that regulate glutamine metabolism and fibrotic development in a TGF-β-dependent manner.
Exploring Black Girls’ Subversive Literacies as Acts of Freedom:

Research on Black girls’ and women’s literacies reveals how they utilize literacy practices to resist oppression and define their identities. Yet, these practices are frequently absent from or marg...
Hallowed Ground: The Gothic New England of Sarah Orne Jewett and Mary Wilkins Freeman

Against a dominant diminished view of rural New England in the late nineteenth century, Mrozowski argues that Sarah Orne Jewett and Mary Wilkins Freeman deployed a Gothic regionalist aesthetic that balanced paltry economic prospects and winnowed worldviews with haunting, excessive descriptions of the landscape that bordered on the mystical and the sacred. Jewett’s Country-By Ways (1881) and Freeman’s Six-Trees (1903) exemplify a Gothic vision compensating for the lost agencies and eroded powers of New England inhabitants. Through lush portraits of stoic trees, ruined farms and unmarked graves, these writers celebrated a local world far richer than some austere Calvinism, more grounded than the new age mysticism of spiritualism and theosophy, and more recalcitrant than the grasping impulses of Gilded age capitalism.
Statistical analysis of microbiome data: The challenge of sparsity

Abstract Microbiomes not only exist across many different body sites in human beings but also interact dynamically with the host and environment. The unique feature and complexity of 16S ribosomal RNA gene sequence data, especially the sparsity of the data, present challenges to statistical analysis and interpretation. Proper normalization is critical in ensuring the validity of downstream analysis. Modeling the inflated zeros is an active area of research, and it has been extended from differential abundance analysis to a variety of other types of analyses. One specific method may not work well under all conditions, where sample size, effect size, data distribution, and degree of zero inflation vary greatly.
A mercury flow meter for ion thruster testing

The theory of operation of the thermal flow meter is presented, and a theoretical model is used to determine design parameters for a device capable of measuring mercury flows in the range of 0 to 5 gm/hr. Flow meter construction is described. Tests performed using a positive displacement mercury pump as well as those performed with the device in the feed line of an operating thruster are discussed. A flow meter response time of about a minute and a sensitivity of about 10 mv/gm/hr are demonstrated. Additional work to relieve a sensitivity of the device to variations in ambient temperature is indicated to improve its quantitative performance.
CureSCi Metadata Catalog – Making sickle cell studies findable

Objectives: To adopt the FAIR principles (Findable, Accessible, Interoperable, Reusable) to enhance data sharing, the Cure Sickle Cell Initiative (CureSCi) MetaData Catalog (MDC) was developed to make Sickle Cell Disease (SCD) study datasets more Findable by curating study metadata and making them available through an open-access web portal. Methods: Study metadata, including study protocol, data collection forms, and data dictionaries, describe information about study patient-level data. We curated key metadata of 16 SCD studies in a three-tiered conceptual framework of category, subcategory, and data element using ontologies and controlled vocabularies to organize the study variables. We developed the CureSCi MDC by indexing study metadata to enable effective browse and search capabilities at three levels: study, Patient-Reported Outcome (PRO) Measures, and data element levels. Results: The CureSCi MDC offers several browse and search tools to discover studies by study level, PRO Measures, and data elements. The “Browse Studies,” “Browse Studies by PRO Measures,” and “Browse Studies by Data Elements” tools allow users to identify studies through pre-defined conceptual categories. “Search by Keyword” and “Search Data Element by Concept Category” can be used separately or in combination to provide more granularity to refine the search results. This resource helps investigators find information about specific data elements across studies using public browsing/search tools, before going through data request procedures to access controlled datasets. The MDC makes SCD studies more Findable through browsing/searching study information, PRO Measures, and data elements, aiding in the reuse of existing SCD data.