cssi/SciSciGPT-SciSciNet huggingface dataset:
Summary of the Centers for Disease Control Human Immunodeficiency Virus (HIV) Performance: Evaluation Surveys for 1985 and 1986

During 1985 and 1986, the Centers for Disease Control conducted eight surveys to evaluate laboratory performance in testing for antibody to human immunodeficiency virus (HIV). (Other names for this virus include “human T-lymphotropic virus type III” and “lymphadenopathy associated virus.”) The first survey was conducted with ten samples and 50 laboratories; the remaining surveys used six samples, but enrollment increased to as many as 475 laboratories. The purpose of these surveys was to measure test performance by the laboratories under the actual conditions of use. The surveys contained duplicate samples to permit measurement of within- and between-survey reproducibility. One survey included positive and negative reference materials as evaluation samples. Results of the Western blot (WB) test were not always positive on samples that were positive by enzyme immunoassay (EIA), and sometimes they were positive on samples that had negative results by EIA. The percentage of positive results reported by laboratories using Electronucleonics tests was lower than that reported by users of Abbott and of Litton tests. Positive results on the negative reference material were reported by 13.7% of the Abbott EIA® test users. The tests do not seem to be calibrated against an equivalent standard. Within-survey reproducibility was usually above 95% for EIA and WB methods and for the major manufacturers of EIA tests. Between-survey reproducibility was usually above 90%. Reproducibility was below 75% for some combinations of samples, method, and manufacturer. The test performance observed in these surveys may be lower than is actually achieved on patient samples because the samples were selected to measure technical competence and contain a higher frequency of samples with low reactivity than would be encountered with clinical samples. Statification and weighting of the results in these surveys to estimate performance parameters for a blood bank population indicate that the tests are performing well in this application. If single EIA tests at the performance levels achieved in these surveys were used (no repeat and no confirmation), about 1 sample with positive results in every 50,000 samples tested would be missed and about 2.5% would be false positive results. Because tests are duplicated and confirmed in blood banks, better performance would be expected. Testing for antibody to HIV virus continues to undergo rapid change because of the introduction of new tests, changes in technical aspects of existing tests, and application of testing to changing populations. Such dynamic factors necessitate an ongoing, comprehensive monitoring of test performance.
White problem gamblers discount delayed rewards less steeply than their African American and Hispanic counterparts.

Impulsivity is a core process underlying addictive behaviors, including non-pharmacological addictive behaviors such as problem gambling. Although considerable attention has been given to the investigation of delay discounting within the context of addiction-related behaviors, relatively little research has examined the relationship between discounting and individual variables, such as race/ethnicity. The purpose of this study was to compare discounting rates in the three most prevalent racial/ethnic groups in the US: Whites, African Americans, and Hispanics. The study was conducted in 315 individuals with problem gambling. Participants completed a delay-discounting questionnaire involving choices between a smaller amount of money delivered immediately and a larger amount delivered later. A hyperbolic discounting function estimated delay discounting rates based on participants’ indifference points obtained via the questionnaires. Results showed significant effects of race/ethnicity on delay discounting. White gamblers discounted delayed money at lower rates than African Americans and Hispanics, even after controlling for confounding variables. These data suggest that among individuals who develop problem gambling, Whites are less impulsive than African Americans and Hispanics, at least in terms of choosing between delayed and immediate reinforcers. These results have implications for evaluating the onset and treatment of addictive disorders from a health disparities perspective.
Enhanced detection and characterization of glutathione-trapped reactive metabolites by pseudo-MS(3) transition using a linear ion trap mass spectrometer.

We present a simple and label-free approach to characterize glutathione (GSH)-trapped reactive metabolites from a single LC-MS analysis employing a linear ion trap mass spectrometer. The GSH specific fragment anion m/z 272 was first generated from the nonselective in-source fragmentation of intact conjugates. GSH conjugates were then detected by selected reaction monitoring (SRM) of the anion pair m/z 272 → 179 or 210. The resultant SRM peaks represented putative GSH conjugates which were then further characterized from their MS and MS2 data acquired in both positive and negative ion modes. The method is demonstrated with test compounds that are all known to form GSH conjugates.
Assessing video games for learning

As we assess games for learning, we should create an inclusive environment that allows for a wide variety of methods. As we publish on assessment, we should be forthright about our foundational assumptions, particularly our epistemologies. We should judge the contribution of assessments taking the stated foundational assumptions as given, but with an eye for improving methods and practices of assessment given those assumptions. Design and development of learning games needs to similarly own their epistemology, design learning goals in keeping with them, and create experiences that conform closely to those epistemologies.
The Transpersonal in Personal Wisdom

The contemplative psychologies are centrally concerned with transformational change in adult psychological development. They do not elevate cognitive complexity to the level of ultimate psychological development but rather to “simplicity on the other side of complexity.” Contemplative psychologies are teleological, with similar goals across traditions. These goals can be seen in terms of “equifinality” – many paths leading to the same goal. The purpose of this chapter is to create a theory of personal wisdom that partakes of the contemplative traditions, including Buddhism, Sufism, and mystical Christianity, among others. We discuss the moral implications of a theory of self-transcendence that unifies all contemplative traditions.
Physicians’ perspectives regarding pragmatic clinical trials

Aim: Practicing physicians inevitably become involved in pragmatic clinical trials (PCTs), including comparative effectiveness research. We sought to identify physicians’ perspectives related to PCTs. Methods: In-depth semistructured interviews with 20 physicians in the USA. Results: Although physicians are generally willing to participate in PCTs, their support is predicated on several factors including expected benefits, minimization of time and workflow burdens and physician engagement. Physicians communicated a desire to respect patients’ rights and interests while maintaining a high level of care. Conclusion: Future work is needed to systematically assess the impact of PCTs on clinicians in meeting their ethical obligations to patients and the burdens clinicians are willing to accept in exchange for potential benefits.
Karyotype, Predictability and Culpability

From the beginning of recorded history, prophets have attempted to foresee harmful occurrences, such as flood, famine, pestilence, earthquake and volcanic eruption. Attempting to predict crime ‐ ‐ to determine who is likely to become a criminal — has also captured the imagination of mankind for centuries. From the Bible’s “stubborn and rebellious son,” identifiable by his gluttony and drunkenness; to Lombroso’s “born criminal and criminaloid,” identifiable by the shape of his cranium; to Sheldon and Eleanor Glueck’s 3 year-old delinquent, identifiable by a composite score derived from familial relationships ‐ ‐ “experts” have claimed the ability to spot the mark of the potential criminal before he or she has committed serious crimes. Though the results have not generally met with scientific approval, it is still widely believed ‐ ‐ by many policemen, judges, psychiatrists, lawyers and members of the general public ‐ ‐ that there are ways of distinguishing real criminals from the rest of us. Most recently, it has been suggested that the presence of the XYY karyotype in a man may be associated with ‐ ‐ and consequently predictive of ‐ ‐ certain kinds of violent crime.
224. Das Schicksal von über 300 Patienten mit Herzschußverletzungen des 2. Weltkrieges

Wenn unter 37 in der Chir. Univ.-Klinik Dusseldorf zur Beobachtung gekommenen Patienten mit Herzsteckschusverletzungen des letzten Krieges 29 Splitter operativ entfernt wurden, handelt es sich um ein ausgewahltes Krankengut, nicht reprasentativ fur die Gesamtzahl dieser Versehrtengruppe.
Closing Arguments: Clarence Darrow on Religion, Law, and Society Edited by S.T. Joshi Athens: Ohio Univ. Press, 2005. 268 pp

(2005). Closing Arguments: Clarence Darrow on Religion, Law, and Society Edited by S.T. Joshi Athens: Ohio Univ. Press, 2005. 268 pp. American Journalism: Vol. 22, No. 4, pp. 103-104.
Chapter 8 – A Kinetic Study of Analyte-Receptor Binding and Dissociation for Biosensor Applications: A Fractal Analysis for Cholera Toxin and Peptide-Protein Interactions

Publisher Summary The chapter discusses the binding of cholera toxin in solution to fluorophore-labeled ganglioside GMI immobilized on a biomimetic membrane surface (supported bilayers of phospholipids), and the binding and dissociation of tyrosine kinase lck SH2 domain in solution to a phosphotyrosine peptide EPQY*EEIPIYL immobilized on a sensor chip. The values of the fractal dimensions and the rate coefficient values for the association (binding), as well as the dissociation phases (where ever it exists), are obtained in the chapter. A fractal analysis of the binding of antigen (or antibody) in solution to antibody (or antigen) immobilized on the biosensor surface provides a quantitative indication of the state of disorder and the binding rate coefficient on the surface. Numerical values are used for the rate coefficients for binding and the dissociation steps to classify the analyte–receptor biosensor system.
Design of a pitch quantization and pitch correction system for real-time music effects signal processing

This paper describes the design of a practical, real-time pitch quantization system intended for digital musical effects signal processing. Like most modern pitch quantizers, this system can be used to pitch correct and even reharmonize out-of-tune singing to alternative musical scales simultaneously (e.g. major, minor, diminished, etc.) Pitch Quantization can also be intentionally exaggerated to produce distinctive effects processing which results in an emotionally inflected and/or “robotic” sound. This system uses intentionally simple signal processing algorithms which make real-time processing possible on constrained devices. In particular, we employ tools such as an octave resolver and range limiter, grain boundary expansion and contraction, and transient detection to enhance the performance of our system.
Northwestern University Flexible Subischial Vacuum Socket for persons with transfemoral amputation-Part 1: Description of technique.

Background:Current transfemoral prosthetic sockets restrict function, lack comfort, and cause residual limb problems. Lower proximal trim lines are an appealing way to address this problem. Development of a more comfortable and possibly functional subischial socket may contribute to improving quality of life of persons with transfemoral amputation.Objectives:The purpose of this study was to (1) describe the design and fabrication of a new subischial socket and (2) describe efforts to teach this technique.Study design:Development project.Methods:Socket development involved defining the following: subject and liner selection, residual limb evaluation, casting, positive mold rectification, check socket fitting, definitive socket fabrication, and troubleshooting of socket fit. Three hands-on workshops to teach the socket were piloted and attended by 30 certified prosthetists and their patient models.Results:Patient models responded positively to the comfort, range of motion, and stability of the new socket wh...
Loss of astrocyte cholesterol synthesis disrupts neuronal function and alters whole-body metabolism

Cholesterol is important for normal brain function. The brain synthesizes its own cholesterol, presumably in astrocytes. We have previously shown that diabetes results in decreased brain cholesterol synthesis by a reduction in sterol regulatory element-binding protein 2 (SREBP2)-regulated transcription. Here we show that coculture of control astrocytes with neurons enhances neurite outgrowth, and this is reduced with SREBP2 knockdown astrocytes. In vivo, mice with knockout of SREBP2 in astrocytes have impaired brain development and behavioral and motor defects. These mice also have altered energy balance, altered body composition, and a shift in metabolism toward carbohydrate oxidation driven by increased glucose oxidation by the brain. Thus, SREBP2-mediated cholesterol synthesis in astrocytes plays an important role in brain and neuronal development and function, and altered brain cholesterol synthesis may contribute to the interaction between metabolic diseases, such as diabetes and altered brain function.
Demographic, Healthcare, and Contextual Factors Associated with Smoking Status Among Sexual Minority Women

Abstract Purpose: The study purpose was to examine demographic, healthcare, and contextual correlates of smoking among sexual minority women (SMW). Methods: Data were from the Chicago Health and Life Experiences of Women study (2010–2012, N = 726). Results: The rate of current smoking was 29.6%, with 29.5% and 40.9% former or nonsmokers, respectively. A history of ever smoking was associated with lower educational levels, having a partner who smokes, heavy drinking, illicit drug use, and a bisexual identity. Statistically significant correlates of former versus current smoker included higher education, having a nonsmoking partner, being from the newest recruited cohort, and less illicit drug use. A past-year quit attempt among current smokers was associated with higher levels of illicit drug use, longer time until first cigarette, and being from the original cohort. Conclusion: The study results highlight key correlates of smoking behaviors among SMW and make an important contribution to the literature on...
Communications coopératives dans les réseaux autour du corps humain pour la capture du mouvement

Les reseaux corporels (WBAN) se refere aux reseaux de capteurs (WSN) "portables" utilises pour collecter des donnees personnelles, telles que la frequence cardiaque ou l'activite humaine. Cette these a pour objectif de proposer des algorithmes cooperatifs (PHY/MAC) pour effectuer des applications de localisation, tels que la capture de mouvement et la navigation de groupe. Pour cela, nous exploitons les avantages du WBAN avec differentes topologies et differents types de liens: on-body a l'echelle du corps, body-to-body entre les utilisateurs et off-body par rapport a l'infrastructure. La transmission repose sur une radio impulsionnelle (IR-UWB), afin d'obtenir des mesures de distance precises, basees sur l’estimation du temps d'arrivee (TOA). Ainsi, on s’interesse au probleme du positionnement a travers de la conception de strategies cooperatives et en considerant la mobilite du corps et les variations canal. Notre premiere contribution consiste en la creation d'une base de donnees obtenue avec de scenarios realistes pour la modelisation de la mobilite et du canal. Ensuite, nous introduisons un simulateur capable d'exploiter nos mesures pour la conception de protocoles. Grâce a ces outils, nous etudions d’abord l'impact de la mobilite et des variations de canal sur l'estimation de la distance avec le protocole "three way-ranging" (3-WR). Ainsi, nous quantifions et comparons l'erreur avec des modeles statistiques. Dans un second temps, nous analysons differentes algorithmes de gestion de ressources pour reduire l'impact de la mobilite sur l'estimation de position. Ensuite, nous proposons une optimisation avec un filtre de Kalman etendu (EKF) pour reduire l'erreur. Enfin, nous proposons un algorithme cooperatif base sur l'analyse d’estimateurs de qualite de lien (LQEs) pour ameliorer la fiabilite. Pour cela, nous evaluons le taux de succes de positionnement en utilisant trois modeles de canaux (empirique, simule et experimental) avec un algorithme (base sur la theorie des jeux) pour le choix des ancres virtuelles.
Increasing awareness of age-related fertility and elective fertility preservation among medical students and house staff: a pre- and post-intervention analysis

Objective To assess medical students' and house staff's knowledge and personal and professional perceptions of age-related fertility and fertility preservation before and after an educational intervention. Design Pre-/post intervention survey. Setting University-based medical center. Patient(s) Medical students and house staff. Intervention(s) An educational session on age-related fertility decline and elective fertility preservation. Main Outcome Measure(s) Knowledge scores and perceptions assessed immediately before and after the intervention. Result(s) Sixty-five surveys were administered. Of the 53 respondents, 71.7% were married or in a committed relationship; 89.4% reported that they were delaying childbearing, with career and/or education being the most frequently listed reason (85.7%); 39.5% indicated that they had both personal and professional interest in fertility preservation but identified finances (62.5%) and time (59.4%) as barriers; 86.9% indicated previous exposure, with formal education (80.0%) and social media (40.0%) being the most common sources. Mean scores on a six-question knowledge-based assessment improved significantly following the presentation (54.6 ± 19.0% vs. 78.1 ± 16.0%), as did the number of participants who indicated that they might now recommend elective oocyte cryopreservation to others (71.1% vs. 54.3%). After the intervention, 97.8% thought that it was important for medical professionals to be informed about age-related fertility decline and elective oocyte cryopreservation. Conclusion(s) Despite professional and personal interest, knowledge of age-related fertility decline and elective fertility preservation is limited among medical students and house staff. This study highlights the need for formal education across all levels of training and specialties, with even brief interventions being of potential benefit.
The Addition of Endovascular Intervention for Dural Venous Sinus Thrombosis: Single-Center Experience and Review of Literature.

Background Dural venous sinus thrombosis (DVST) is a cause of infarction and intracranial hemorrhage (ICH) that can lead to significant morbidity. Endovascular therapy has emerged as an adjunctive therapy in select cases but has been associated with increased hemorrhagic complications. We present our experience with a large single-center cohort of DVST cases treated with current-generation thrombectomy devices. Materials and Methods In this retrospective cohort study, a chart review was performed to compare presentations and outcomes of patients treated with anticoagulation alone with those treated with additional interventional therapy, using the modified Rankin Scale (mRS) score at discharge and at 90 days' follow-up. Results A total of 66 patients were included; 37 were treated with anticoagulation alone, and 29 underwent additional interventional therapy. Patients presenting with ICH or infarction had a significantly greater likelihood of disability at the time of discharge (odds ratio [OR] of 64.5 and 45.8, respectively; P P P P = .05), but outcomes were not significantly different at 90 days ( P = .19). Conclusions Despite a higher rate of ICH or infarction at presentation in the endovascular group and an increased risk of postprocedural ICH, both treatment groups had similarly good functional outcomes at 90 days.
Summary and Synthesis

Many farm and food policies that have been proposed to reduce obesity will not be effective, economic, or politically acceptable. Farm subsidies and the Supplemental Nutrition Assistance Program (SNAP) have not contributed to obesity, and although public agricultural RD however, food taxes are regressive and might not be politically acceptable. Policies that induce the food industry to redesign foods may be more effective at reducing obesity than policies that rely entirely on inducing response by consumers. Policies that combine the push of market incentives with the pull of public education and nudging interventions may be the best of all.
Performance evaluation of catalysts in the dry reforming reaction of methane via the ratings concept

The concept of reactivity and stability ratings is proposed as a screening tool for identification of reactive and stable catalysts in the dry reforming reaction of methane (DRR), in which reactivity and stability against coking are the largest concerns. The rating concept links the activation energy (Ea) of selected sets of elementary steps corresponding to DRR reactivity and stability for a particular catalyst with respect to the Ni(111) reference catalyst. This is done by transforming the Ea into reactivity rating (RT-R) and stability rating (RT-S) by applying a rating scale. A specific rating scale is defined in order for any system to be compared using the indexes on the reactivity surface (RS) and stability surface (SS). RS and SS were constructed as functions of RT-R and RT-S to illustrate reaction and coking schemes, together with the rate of reaction and coking at any value of these rating indexes. Hence, the concept could evaluate the catalyst qualitatively and quantitatively. Moreover, guidelines to achieve reactive-stable catalysts are proposed from the analysis of the RS and SS indexes, along with the application of the rating concept not only for describing the reactivity and stability of the Ni–Ni3C–NiO catalyst system during DRR, but also to suggest what compositions of each phase would yield high reactivity and stability of the system.
LEARNING DEMOCRACY IN THE NEW GILDED AGE

Can democracy be learned? The election of Donald Trump has reinvigorated debates about the practice and process of democratic governance. It has highlighted the ways in which political behavior and ideologies are rooted in different cultures and geographies, and, in our new Gilded Age, the effects of the increasing polarization of the wealthy few and the 99 percent. These conditions make it an opportune time to reexamine earlier social critics who pointed to an array of institutions to combat political and economic inequality. Pragmatist thinkers, John Dewey foremost among them, considered the electoral process only one facet of a democratic ideal that citizens would need to strive to realize in the economic, social, and cultural realms. “Democracy” described not only a political system, but also an egalitarian “mode of associated living.” Such a way of life did not take place exclusively in the realm of formal politics, but in any instance of communal activity. Most importantly, democracy was a learned disposition: a form of egalitarian human organization that could only emerge if individuals developed the right habits of mind and used their shared intelligence to build inclusive communities of mutual flourishing.
Darkness on the Edge of Town: Visual Criminology and the "Black Sites" of the Rural

ABSTRACT“Black” has long been employed to inspire or communicate horror, isolation and dread. Employed the state and capital, from the CIA and municipal police departments to corporations, the “black site” is a geography that conceals the knowledge of its own existence and boundaries. “Rurality” is a spatial concept characterized by the unknown and the blurred edges of its own temporal and material existence. Taking the common rural prison and Contained Animal Feeding Operations (CAFOs) as examples of rural “black sites”, we contend that efforts to render them visible can be enhanced by the lessons of paranormal/spirit photography.
The Mediation Solution

In his notes for a law lecture, no less a legal mind than Abraham Lincoln advised, “Discourage litigation. Persuade your neighbors to compromise whenever you can. Point out to them how the nominal winner is often a real loser — in fees, expenses, and waste of time.” Little has changed since Lincoln’s time. Litigation remains a slow, inefficient, expensive, acrimonious, and unpredictable process that airs problems in full public view. Mediation, on the other hand, offers a way to resolve legal disputes effectively, efficiently, and privately — and at a reduced cost. While a few business courses briefly discuss alternative dispute resolution (ADR), which includes mediation and arbitration, it’s our experience that most undergraduate business law courses generally pay scant attention to this topic. And we believe mediation is too important in the real world to relegate to a small cameo in the curriculum.
Information utility in the human brain.

A funding agency just made a decision about your grant application. The official letter should arrive tomorrow, announcing the outcome, but you can log in to the agency’s website and find out today. Would you? Humans and other animals are intrinsically motivated to acquire information, even when this information is of no instrumental value. This makes sense—after all, “knowledge is power” and, outside of the laboratory, information can guide action, to maximize gains and avoid harm. However, in some cases, people prefer to avoid information (1), particularly when this information is likely to validate a negative prediction. Recent theories propose that information carries its own utility—positive utility if the knowledge is likely to confirm a desirable belief (e.g., that your grant will be funded) and negative utility if it is more likely to support an undesirable belief (that your grant will not be funded). In PNAS, Charpentier et al. (2) use a novel experimental paradigm to provide behavioral support for these theories as well as evidence for neural encoding of the utility of information which is consistent with the theories. In an fMRI experiment (Fig. 1), participants were presented with monetary lotteries. On some trials, the lottery offered a chance for winning $1 (or winning nothing); on other trials, the lottery presented a chance for losing $1 (or losing nothing). The probability for winning or losing (between 0.1 and 0.9) was conveyed in the form of a pie chart. Participants could not affect the outcome in any way, and this was made clear to them. They could, however, express their preference for finding out the outcome on each trial. Participants did this by choosing one of two options, offering different probabilities for revealing the outcome. After making the choice, participants were notified whether they would receive the information (knowledge cue) … [↵][1]1Email: ifat.levy{at}yale.edu. [1]: #xref-corresp-1-1
A Social Justice Perspective on Intellectual Property, Innovation, and Entrepreneurship

Innovation, the creating of new things or processes, is a core factor in development, but it is not sufficient for development; the innovations must be exploited effectively in the marketplace. An intellectual property regime that favors too strongly one interest over another, as for example on the one hand by making the property holder’s interests too strong thereby limiting the social utility of the work, or on the other hand by making the user’s rights too strong thereby limiting the incentive for an inventor or writer to create, can lead to stagnation.
Approximation of Usual and of Generalized Solutions

In this chapter we cover first the question of approximating absolute continuous solutions by means of C1 solutions for Lipschitzian problems (Section 18.1). In particular we state and proved Angell’s theorem, which includes most previous results, in terms of the same property (D) we have used in Chapter 13 for a far different purpose. In Section 18.2 we then present a simple example due to Mania which shows that the just-mentioned approximation, in general, may not be possible (Lavrentiev’s phenomenon). In Section 18.3 we present a proof that generalized solutions for Lipschitzian problems can be approximated by means of usual absolutely continuous solutions, and in Section 18.4 we show by means of an example that such an approximation, in general, may not be possible.
Homolytic replacement of a hydrogen atom in 2-methylquinoline by A 1,3-dioxolanyl residue

The reaction of 1,3-dioxolane with sulfuric-acid-protonated 2-methylquinoline initiated by the ROOH + Fe2+ system [where R = H, (CH3)3C, or C6H5C(CH3)2] at 5–10 °C in water forms 4-(1,3-dioxacyclopent-2-yl)-2-methylquinoline and 4-(1,3-dioxacy-clopent-4-yl)-2-methylquinoline. The selectivity of the formation of the first reaction product increases on passing from hydrogen peroxide to cumyl and tert-butyl hydroperoxide and with an increase in the pH of the medium.
Creative Intelligence, Creative Practice: Lowenfeld Redux.

Volume 1, No. 2, of Studies in Art Education, appearing in spring 1960, included an article by Viktor Lowenfeld titled “ Creative Intelligence.” Here, he highlighted his belief in the importance of creative intelligence to human functioning, linking it to creative practice as represented most purely in the artworks of children and untutored artists. The present article written with over 60 years of hindsight, offers a gentle critique of Lowenfeld’s theory of creative intelligence as exemplified within his concepts of developmental stages, growth components, and final outcomes. Yet, by paring away some of his outmoded surfaces, there lurks within Lowenfeld’s seminal offering to art education the enduring idea that creative practice offers ways of knowing and world-building that enliven knowledge through acts of personal generativity.
Contemporary Considerations in Mitral Valve Surgery

The ACC/AHA guidelines for intervention for mitral stenosis are shown in Fig. 1. Patients must have at least moderate mitral stenosis to warrant mitral replacement or balloon valvuloplasty. Patients also should be reasonably symptomatic with NYHA class III or IV symptoms. Other indications include significant pulmonary hypertension (peak pulmonary pressure >50 mm Hg) and/or recent onset atrial fibrillation. Patients with mitral valve morphology suitable for balloon valvuloplasty ideally should be referred for balloon valvuloplasty, given the good results and lower morbidity and mortality than mitral commissurotomy (2). An established echocardiographic scoring system is generally used to decide favorable valve morphology for balloon valvuloplasty, and it includes an evaluation of mitral valve leaflet thickness, calcification, and mobility as well as an assessment of submitral chordal fusion (3). Contraindications for balloon valvuloplasty include left atrial thrombus and more than moderate degree of mitral regurgitation. In the current era in the United States, mitral stenosis implies a high probability of mitral replacement, given that percutaneous balloon valvuloplasty is usually preferable treatment for mitral stenosis patients with valve morphology suitable for repair.
HYPOXIA AND HYPOXEMIA

Hypoxemia and hypoxia refer to conditions of decreased oxygen concentration in arterial blood and in the peripheral tissues, respectively, that may be experienced by individuals exposed to extreme environmental conditions (high altitude), accidental conditions (diving accidents, near drowning, and carbon monoxide poisoning), or with diseases that affect the transport of oxygen to the tissues. If untreated, hypoxemia and hypoxia may lead to organ dysfunction and eventually to death. Anaerobic sources of energy help supplement faltering aerobic energy production during hypoxia. Treatment of hypoxemia and hypoxia should be directed at the resolution of the precipitating cause.
Mothers in academic pharmacy

Abstract Introduction The proportion of women pharmacists has been rapidly increasing for many years, from 43.3% of licensed pharmacists in 2000 to 52.7% in 2014. Yet women may be less likely to consider certain positions in pharmacy due to concerns of balancing work and motherhood responsibilities. The terms “motherhood penalty” and “baby penalty” have been used to describe the consequences of child-bearing responsibilities on the careers of women, including academic pharmacy. Many workplaces have established interventions to address the motherhood and baby penalties, including policies such as extended child-bearing leave and better childcare options. Commentary and implications However, there is still much understanding and improvement needed from the pharmacy academy administration to elicit a true change in culture. How can we create this culture shift? This article emphasizes a call to action to address this need for change.
Value of anterosuperior rotator cuff and labral tears at MRI for predicting long head of biceps tearing at arthroscopy.

Aim To determine whether magnetic resonance imaging (MRI) signs of subscapularis (SBT), supraspinatus (SST), or superior labral tearing predict long head of biceps (LHB) tendon tearing at arthroscopy. Materials and methods Subjects with MRI studies followed by arthroscopy were collected. Radiologists graded rotator cuff (RC) tendons and the superior labrum using three grade classifications and blinded to arthroscopy. Correlation between imaging variables and surgical outcome was expressed in terms of odds ratios and determined using a stepwise logistic regression model. Results Selection criteria identified 89 participants. Statistically significant increase in odds of finding a partial LHB tendon tear at arthroscopy were noted for both MRI readers with any SBT tear (OR=4.1–5.6, p Conclusion LHB tendons should be closely scrutinised if anterosuperior rotator cuff tears, and SBT tears in particular, are found on MRI.
Levodopa-induced dyskinesias in Parkinson disease: a population based-cohort study in Olmsted County, MN (1991–2010) (P2.059)

Objective: To assess the frequency of dyskinesias in a population based-cohort of Parkinson’s disease patients. Background: Levodopa-induced dyskinesias are complications that may impact quality of life. Design/Methods: We analyzed the population-based incidence cohort of 669 parkinsonism residents of Olmsted County, MN, identified between 1991–2010 through the Rochester Epidemiology Project. From the medical records, we selected Parkinson’s disease (PD) patients and abstracted information on PD-medications, dyskinesia-onset and maximum severity. Results: We identified 309 PD cases (46.2% of parkinsonisms); among these, 279 (90.3%) were treated with levodopa. The vast majority (230/279; 82.4%) had been treated by a Mayo neurologist. Duration of levodopa treatment in this incident cohort ranged from 2 to 21 years (median 9 years). Dyskinesias were documented in 30.1% (N=84). Median time from levodopa-initiation to dyskinesias was 4 years (range: 2 months–20 years) and 65.5% (55/84) developed dyskinesias within 5 years of levodopa initiation (8 within the first year of treatment). Dyskinesias were rated as mild in 57/84 (67.9%), moderate in 16/84 (19.1%) and severe in 9/84 (10.7%); dyskinesias severity was not reported in 2 cases. Medication adjustments or amantadine was used in 60.7% (51/84), with marked improvement in 23 (45.1%). All 13 cases that underwent deep brain stimulation (DBS) reported marked dyskinesia improvement (15.5% of dyskinetic patients). Brain autopsy was available in 7 patients (median: 4 years from dyskinesias to death): all had a pathological diagnosis of subcortical Lewy body disease with minimal cortical deposits; all 7 had Alzheimer’s neuropathology. Conclusions: Levodopa-induced dyskinesias affected 30% of PD patients in our incident cohort. Mayo neurologists who favored optimized levodopa dosing treated most of the patients. Dyskinesias were severe in only 3% of all levodopa-treated PD patients (11% of all dyskinetic patients), with marked improvement among those treated with DBS. Disclosure: Dr. Turcano has nothing to disclose. Dr. Mielke has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Eli Lilly, Lysosomal Therapeutics, Inc. Dr. Bower has nothing to disclose. Dr. Parisi has nothing to disclose. Dr. Ahlskog has nothing to disclose. Dr. Savica has nothing to disclose.
Pregnancy and Cholelithiasis

Pregnancy predisposes women to cholelithiasis due to the hormonal effects of estrogen and progesterone on cholesterol, soluble bile acid secretion, and gallbladder emptying. Gallstones cause biliary colic, acute cholecystitis, gallstone pancreatitis, choledocholithiasis, gallstone ileus, and cholangitis. Signs and symptoms include intermittent right upper quadrant pain, nausea, vomiting, epigastric pain, anorexia, intolerance of fatty foods, fever, elevated white blood cell count, elevated amylase and lipase, elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT), jaundice, and positive Murphy’s sign. Findings of cholecystitis on ultrasound are thickened gallbladder wall (>3–5 mm) or edema, presence of gallstones, pericholecystic fluid, and a sonographic Murphy’s sign. Cholecystectomy is clearly indicated for obstructive jaundice, acute cholecystitis failing medical therapy, gallstone pancreatitis, or suspected peritonitis. Conservative management has a 38% chance of suboptimal outcome, with a 34% risk of relapse, and increased severity of disease at relapse. The consideration for definitive surgical management of gallstone disease during pregnancy, especially in the first and second trimesters, is supported.
New approach to determining radiative capture reaction rates at astrophysical energies

Radiative capture reactions play a crucial role in stellar nucleosynthesis but have proved challenging to determine experimentally. In particular, the large uncertainty ($\sim$100%) in the measured rate of the $^{12}$C$(\alpha,\gamma)^{16}$O reaction is the largest source of uncertainty in any stellar evolution model. With development of new high current energy-recovery linear accelerators (ERLs) and high density gas targets, measurement of the $^{16}$O$(e,e^\prime \alpha)^{12}$C reaction close to threshold using detailed balance opens up a new approach to determine the $^{12}$C$(\alpha,\gamma)^{16}$O reaction rate with significantly increased precision ($<$20%). We present the formalism to relate photo- and electro-disintegration reactions and consider the design of an optimal experiment to deliver increased precision. Once the new ERLs come online, an experiment to validate the new approach we propose should be carried out. This new approach has broad applicability to radiative capture reactions in astrophysics.
TeraPCA: a fast and scalable software package to study genetic variation in tera-scale genotypes.

MOTIVATION Principal Component Analysis is a key tool in the study of population structure in human genetics. As modern datasets become increasingly larger in size, traditional approaches based on loading the entire dataset in the system memory (Random Access Memory) become impractical and out-of-core implementations are the only viable alternative. RESULTS We present TeraPCA, a C++ implementation of the Randomized Subspace Iteration method to perform Principal Component Analysis of large-scale datasets. TeraPCA can be applied both in-core and out-of-core and is able to successfully operate even on commodity hardware with a system memory of just a few gigabytes. Moreover, TeraPCA has minimal dependencies on external libraries and only requires a working installation of the BLAS and LAPACK libraries. When applied to a dataset containing a million individuals genotyped on a million markers, TeraPCA requires <5 h (in multi-threaded mode) to accurately compute the 10 leading principal components. An extensive experimental analysis shows that TeraPCA is both fast and accurate and is competitive with current state-of-the-art software for the same task. AVAILABILITY AND IMPLEMENTATION Source code and documentation are both available at https://github.com/aritra90/TeraPCA. SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.
Dual antiplatelet therapy in non-ST elevation acute coronary syndromes at Veterans Affairs Hospitals

Objective Current guidelines recommend that patients with non-ST elevation acute coronary syndromes (NSTEACS) receive dual antiplatelet therapy (DAPT) early in hospitalisations. However, observational studies suggest that this rarely occurs. We evaluated site-specific variation and clinical outcomes associated with early DAPT among patients undergoing angiography for NSTEACS. Methods In this observational analysis, we identified patients undergoing angiography for NSTEACS in Veterans Affairs hospitals from 2008 to 2016 and assessed characteristics and site variation associated with early DAPT (administration Results Of 45 569 patients undergoing angiography for NSTEACS, 15 084 (33%) received early DAPT. Early DAPT was more frequent in patients with non-ST elevation MI, prior surgical revascularisation and among patients undergoing revascularisation. There was a greater than twofold difference in early DAPT across sites, independent of patient characteristics (median OR 2.43, 95% CI 2.28 to 2.55). There was no difference in time topercutaneous coronary intervention (PCI) between groups, but a significant delay to surgical revascularisation with early DAPT (median 4 vs 3 days, p Conclusion Among NSTEACS patients undergoing coronary angiography, early DAPT was not associated with improvement of outcomes but was associated with delays in surgical revascularisation.
Using smart garments to differentiate among normal and simulated abnormal gaits

Abstract Detecting and assessing an individual’s gait can be important for medical diagnostic purposes and for developing and guiding follow-on rehabilitation protocols. Thus, an accurate, objective gait classification system has the potential to facilitate earlier diagnosis and improved clinical decision-making. Systems using smart garments represent an emerging technology for physical activity assessment and that may be relevant for gait classification. The objective of this study was to assess the accuracy of one such system – comprised of commercial instrumented socks and a custom instrument shirt – for differentiating among normal gait and four distinct simulated gait abnormalities. Eleven participants completed an experiment in which they completed several gait trails on a single day. Gait types were classified using diverse modeling approaches (K-nearest neighbors, linear discriminant analyses, support vector machines, and artificial neural networks). High classification accuracy could be obtained, both when classification models were developed and tested using data from each participant separately and grouped together, particularly using the k-nearest neighbor method (>98% accuracy). Some gaits were more often “confused” with other gaits, especially when they shared underlying kinematic aspects. These results support the potential of using “smart” garments for detecting and identifying abnormal gaits, and for future implementation in diagnosis and rehabilitation.
Ras Tanura Oil Terminal Experience With Reliability and Safety of Motors Circuits

Oil Terminal depend on large size motors to ship oil to the tankers. The intermittent Operations of those motors increases the risk of failure to starts events not only due to problems in the motors but also in other components in the motor circuits. 9 real cases of motors failures to start are presented, classified under 5 categories; namely, motor management relays, motor starters, circuit breakers, power cables, and excitation systems. These cases are coupled with immediate and root cause analysis, and lessons learned. The safe work practices followed to mitigate arc flash and electric shock hazards while performing maintenance on the motor circuits are also presented for the cases of insulation resistance tests, motor online and offline tests, and thermography.
Endoscopic incisional therapy and other novel strategies for effective treatment of congenital esophageal stenosis.

Abstract Background & aims Congenital esophageal stenosis (CES) is an inborn condition of the esophagus that can be refractory to endoscopic dilation. Surgical intervention is not curative, with patients experiencing frequent ongoing need for therapy for anastomotic stricture postoperatively. We hypothesized that novel methods of endoscopic CES management including endoscopic incisional therapy (EIT) would lead to less surgical intervention. Methods We retrospectively reviewed the medical records of all patients with CES treated by our tertiary care center who had at least one endoscopy between July 2007 and July 2019. Statistical comparison of cohorts who underwent advanced endoscopic therapy involving EIT versus traditional endoscopic therapy with balloon dilation was performed. Primary outcome measure was need for surgical intervention. Results Thirty-six patients with CES met inclusion criteria. Thirty-four ever had at least one endoscopic intervention such as balloon dilation, steroid injection, stenting, and/or endoscopic incisional therapy (EIT) at their CES. Esophageal vacuum assisted closure (EVAC) was used for treatment or prevention of esophageal leak. Odds of surgical intervention were significantly lower in the group who received therapeutic endoscopy with EIT (odds ratio (OR) 0.1; p = 0.007). Clinical feeding outcomes were similar in the endoscopic and surgical management groups. Odds of complications after therapeutic endoscopies involving EIT were significantly greater than those without EIT (odds ratio 6.39; 95% confidence interval (2.34, 17.44); p Conclusion Complementary endoscopic techniques such as EIT broaden the toolbox of the treating physician and may allow for avoidance of surgery in CES. Level of evidence Level III.
Cultural Humility and the Practice of Consultation-Liaison Psychiatry.

Abstract Background Cultural competency has long been the gold standard for clinicians who treat patients of different races and/or cultural backgrounds than their own. However, in recent years, there has been increasing criticism of the cultural competency framework because of its reliance on stereotypes and an overemphasis on knowledge acquisition. Objective We review this transition, including the critiques of cultural competency. We highlight trends in psychiatrist diversity, education, and training on cultural humility, including how consultation-liaison psychiatrists can incorporate advances in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, regarding the role of culture in clinical diagnosis, treatment, and management. Methods We review the transition from cultural competency to cultural humility, including the critiques of cultural competency. We highlight trends in psychiatrist diversity, education, and training on cultural humility. Results We illustrate how consultation-liaison psychiatrists can incorporate advances in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, regarding the role of culture in clinical diagnosis, treatment, and management. Conclusions Cultural humility, which minimizes the power imbalance between clinicians and patients and emphasizes patient-focused interviewing and care, is a useful approach for consultation-liaison psychiatrists working with diverse patients and with diverse multidisciplinary teams in the general hospital.