cssi/SciSciGPT-SciSciNet huggingface dataset:
Medical Director Education Belongs in a Geriatrics Fellowship Curriculum

In this issue of the Journal, Dr Higuchi and colleagues1,2 report on the evaluation strategy for their curriculum in medical direction that was published in an earlier issue of this journal. Higuchi et al1,2 used a framework developed by the American Medical Directors Association (AMDA) on the roles and responsibilities of the medical director to assist learners in developing a systematic approach to problem solving in the nursing home. In this framework, the medical director steps out in 4 directions: (1) provides leadership and guidance to the clinical providers within the facility, (2) guides clinical care within the facility from a process and policy perspective, (3) participates in quality improvement endeavors, and (4) champions education and effective communication. Within this framework, learners are encouraged to operate in a manner that promotes partnership among the professionals who must work together in the nursing home, and encourages the other professionals to view the medical director as a valued consultant and leader who moves care in the direction of person-centered and person-directed care. The content provided in 7 sessions included (1) roles and responsibilities of the medical director, (2) infection control, (3) physician documentation, (4) federal regulations and state surveys, (5) quality improvement, (6) culture change in nursing homes, and (7) transitions in care. Similar curriculum could be easily incorporated into most geriatric fellowship programs. It should not be difficult to find at least one certified medical director among the faculty of each geriatrics fellowship program, given the long-standing requirement that geriatrics fellows receive part of their training in a skilled nursing facility and follow patients longitudinally in this setting throughout their clinical year of training. Although Higuchi and colleagues’ first article1 was outstanding, leading the direction toward well-developed medical director curriculum, the article in this issue2 is even more pivotal because it provides a validated means of learner assessment. I am not concerned that they did not find much change in attitudes on their assessment. I think this has more to do with how the questions were asked than whether attitudes were changed. I suspect these fellows actually came to realize that being a well-trained clinical geriatrician is not enough, specific knowledge and skills are needed that they would not have acquired except for this new curriculum. Also, they clearly began to realize that effective medical directors are
Temperature-dependent reaction kinetics of NH (a1Δ)

Abstract The gas-phase reactions of NH(a 1 Δ) with H 2 and selected saturated and unsaturated hydrocarbons have been studied over the 250-600 K temperature range. Olefin reactions proceed at near the gas kinetic collision rate and show no temperature dependence. H 2 and saturated hydrocarbons show temperature-dependent reactions rates, with activation energies of = 0.8-2 kcai/mole. No evidence of electronic quenching of NH(a 1 Δ) to the ground state was observed with any of the hydrocarbons studied. First-order reactions rates, Arrhenius A factors and activation energies for the reactions are reported. We discuss a mechanistic interpretation of the kinetics in view of earlier kinetic and reaction-product studies and ab initio SCF Cl calculations.
Stiffness matrix and quantitative measure of formation rigidity

Rigidity of formation is an important concept in multi-agent localization and control problems. There are well-developed existing methods to test rigidity of a given graph. However, little work is done on quantitative measurement of formation rigidity. In this paper, the concept of stiffness matrix of a formation is proposed to represent both its rigidity and structural information, from which we then derive the worst-case rigidity index that can be used as an applicable quantitative measure of formation rigidity. Its validity is shown through the establishment of its related properties that conform to intuitive assumptions and practical applications as well as some examples.
High speed implementation of matrix inversion algorithms in orthogonal systolic architectures

The implementation of matrix inversion algorithms using the few instructions, multiple data, systolic architecture concept is presented. Specifically, two matrix inversion algorithms, one general and one for symmetric matrices, are implemented and incorporated in the architecture. To achieve high computational throughput, the systolic architecture is implemented using the logarithmic number system. >
Results of balloon valvuloplasty in the treatment of congenital valvar pulmonary stenosis in children

Abstract Transluminal balloon valvuloplasty was used in the treatment of congenital valvar pulmonary stenosis in 19 children, aged 5 months to 18 years. The right ventricular (RV) systolic pressure and RV outflow tract gradient decreased significantly immediately after the procedure (95 ± 29 vs 59 ± 14 mm Hg, p
PFEFFER'S Barriers to The Advance Of Organizational Science: A Rejoinder

Pfeffer's (1993) discussion of the causes and consequences of paradigm development led him to the conclusion that organizational scholars should place control over publication into the hands of a comparatively small elite group who would force a consensus by excluding views that diverge from a dominant paradigm. In his view. this action would lead to a number of positive benefits for organizational scholars and organizational studies in general. We argue from a different set of assumptions than those of Pfeffer. In our view. knowledge is socially constructed, and. thus, scholars are unable to make unambiguous claims on some absolute truth. Given this assumption, the enforced consensus and dominant paradigm called for by Pfeffer would lead to a stagnation in knowledge evolution. Further. we argue that the concept of consensus and its role in the evolution of knowledge has been overstated. In contrast to Pfeffer. we conclude that a high degree of consensus, however achieved, would suggest that the evolution...
Oxygen and animals in Earth history.

In the annals of Earth history, few associations have proven more iconic or durable than that between animals and oxygen. As early as 1919, the experimental physiologist August Krogh (1) explored the relationship between O2 and animal anatomy, and 40 y later J. R. Nursall (2) posited explicitly that metazoans appear as fossils only in uppermost Proterozoic rocks because pO2 was insufficient to support animal physiology before this time. Preston Cloud, the first great historical geobiologist, championed this idea (3), and in recent years the hypothesis has been bolstered by geochemical data that place redox transition in broad synchrony with the first animal body fossils (4). Now, however, Mills et al. (5) challenge this view of life, at least in its simplest form.
Full length article: Riesz polarization inequalities in higher dimensions

We derive bounds and asymptotics for the maximum Riesz polarization quantity M"n^p(A)@?maxx"1,x"2,...,x"[email protected][email protected][email protected]?j=1n1|x-x"j|^p (which is n times the Chebyshev constant) for quite general sets [email protected]?R^m with special focus on the unit sphere and unit ball. We combine elementary averaging arguments with potential theoretic tools to formulate and prove our results. We also give a discrete version of the recent result of Hardin, Kendall, and Saff which solves the Riesz polarization problem for the case when A is the unit circle and p>0, as well as provide an independent proof of their result for p=4 that exploits classical polynomial inequalities and yields new estimates. Furthermore, we raise some challenging conjectures.
Blind deconvolution of linear systems with nonstationary discrete inputs

A method is proposed for blind deconvolution (equalization) of communication channels when their input signals are real- or complex-valued multilevel random sequences. The gist of the method is to apply a linear filter (equalizer) to the observed signal and to adjust it until a multilevel sequence is obtained from the output. It is shown that the problem can be solved with only scale/rotation and shift ambiguities. A cost function is proposed so that any minimizer of the function provides a solution to the problem. When the channel is parametric, a procedure is presented for the consistent estimation of the channel parameters. All these results are obtained for nonminimum phase linear systems without assuming the stationarity of the signal. >
Stereotactic Body Radiation Therapy for Tumors of the Pancreas

More than 42,000 new cases of pancreatic cancer are diagnosed each year in the United States. Pancreatic cancer is the fourth leading cause of cancer-related deaths, and is the second leading cause of digestive cancer-related deaths. Even with the most aggressive combined modality therapy, the overall 5 year survival currently remains less than 5% (Jemal et al. 2009).
The regulatory subunit Vb of cytochrome c oxidase is required for malignant transformation

A83 Cytochrome c oxidase (COX) is an enzyme complex within the electron transport chain that is central to the regulation of aerobic metabolism. Recently, the expression of the nuclear encoded regulatory subunit of COX, subunit Vb, was found to be markedly increased in several tumor tissues as compared to matched normal tissues. These tumor cells have an increased utilization of oxygen when compared to normal cells. In addition, the oncogene ras is activated in ~ 30% of all human neoplasms and is known to increase oxygen consumption in immortalized cells. We hypothesized that ras may increase oxygen consumption through upregulation of COX Vb expression. We found that ectopic expression of ras in immortalized human bronchial epithelial cells caused a marked increase in COX Vb protein expression which coincided with increased oxygen consumption. Based on the induction of COX Vb by ras, we postulated that COX Vb regulated enhancement of mitochondrial electron transport may be required for neoplastic growth. We selectively decreased COX Vb protein expression by transfecting siRNA species into HeLa cervical adenocarcinoma and A549 lung adenocarcinoma cells and observed a suppression of COX activity, oxygen consumption, cell proliferation, and soft agar colony formation, relative to control untransfected and lamin-targeted siRNA transfected cells. Disruption of aerobic respiration caused a compensatory increase in lactate secretion, a measure of anaerobic glycolysis, in order to maintain adequate ATP production. Our findings indicate that oncogenic ras may activate mitochondrial electron transport through COX Vb in order to enable the untethered growth of transformed cells. We are currently completing studies to assess the effects of COX Vb suppression on the Krebs cycle activity. Because the Krebs cycle relies on mitochondrial respiration and is an important source of anabolic precursors such as pyrimidine bases and amino acids, we believe suppression of COX Vb may inhibit Krebs activity and thus limit transformed cell growth. We conclude that targeting COX Vb activity alone or in combination with anti-glycolytic therapies may represent a novel chemotherapeutic strategy, and future studies will be directed at determining the in vivo tumor effect of COX Vb inhibition.
Technical Results of Vacuum-Assisted Thrombectomy for Arterial Clot Removal in Patients with Acute Limb Ischemia

Abstract Purpose To assess the efficacy and safety of a vacuum-assisted thrombectomy (VAT) catheter system for treating patients with acute limb ischemia (ALI). Materials and Methods A retrospective study evaluated VAT systems (Penumbra, Alameda, California) in a consecutive series of 30 patients with ALI. ALI was defined as clinical symptoms within 2 weeks of presentation. The primary endpoint was improvement in blood flow across a lesion by improvement in Thrombolysis in Myocardial Infarction (TIMI) score that was adapted to peripheral arteries. Concomitant balloon angioplasty or stent placement in addition to VAT was considered a complementary treatment. Additional thrombectomy treatments, such as thrombolysis and mechanical thrombectomy, were considered technical failures. Target lesions were grouped anatomically into above-the-knee (ATK) or below-the-knee (BTK) lesions. Results In 30 patients, 33 lesions (ATK, n=13; BTK, n=20) were treated. No complications were attributed to the VAT systems. The primary endpoint was obtained in 24/33 (72.7%) lesions (BTK, 17/20 [85.0%]; ATK, 7/13 [53.9%]; P = .050 by χ 2 test). TIMI scores were similar at baseline but differed after VAT between the ATK and BTK groups ( P t test). ATK lesions required more concomitant angioplasty or stent placement, or both ( P 2 test). Conclusions VAT is a safe, technically successful short-term therapeutic option for thrombus removal in patients with ALI.
On Martingale Extensions of Vapnik–Chervonenkis Theory with Applications to Online Learning

We review recent advances on uniform martingale laws of large numbers and the associated sequential complexity measures. These results may be considered as forming a non-i.i.d. generalization of Vapnik–Chervonenkis theory. We discuss applications to online learning, provide a recipe for designing online learning algorithms, and illustrate the techniques on the problem of online node classification. We outline connections to statistical learning theory and discuss inductive principles of stochastic approximation and empirical risk minimization.
Active Constituent of Local Anesthetic Solutions

Such local anesthetics as are salts of weak bases and strong acids—and most local anesthetics come under this chemical classification—have repeatedly been shown to be more effective, particularly f...
Cooling Facilities of Rubber Equipment

Abstract Proper maintenance of rubber processing equipment is a necessary and important phase of production. If management is to maintain maximum overall production it must allow the engineering and maintenance organization sufficient authority, time and money to keep equipment operating at top efficiency. When the pressure of production jobs that have to be completed “yesterday” interferes repeatedly with repairs that should have been made last week, the chances are very good that a condition will soon exist where the rush job can not be completed until next month. The first rule, then, in maintenance work is, “Do it now.” A small repair job today may prevent a costly shutdown tomorrow. In addition to the mechanical difficulties regularly occurring, there are a number of little things that frequently cause production delays and hidden extra costs. One of the most important of these concerns the cooling of mills, Banbury mixers, calender rolls and tubing machines. Early in the history of the rubber indust...
Adult responses to a survey of soil contact-related behaviors.

Protocols used to assess human exposure to chemicals in soils at contaminated sites often include a dermal pathway. Use of default parameters to assess dermal exposure to soil can easily lead to risk projections that appear to warrant remedial action. However, because those default parameters are typically highly uncertain, risk estimates based upon them inspire little confidence. To better characterize assumptions regarding dermal exposures, a telephone survey instrument was developed to elicit information on behaviors relevant to assessment of dermal contact with soil and dust. Participation in four activities--gardening, other yard work, outdoor team sports, and home construction or repair involving digging--was investigated. Questions were also asked regarding clothing choices and post-activity bathing practices. The survey was administered to two populations of approximately 450 adult respondents each using random digit dialing. The first was a national (U.S.) sample. The second sample was drawn from counties surrounding the Hanford Nuclear Reservation. Seventy-nine percent of the regional respondents and 89% of the national respondents reported participating in at least one of the four targeted activities. Responses of doers regarding clothing choices suggest that median fractions of skin exposed during warm-weather activities typically exceed the 25% often assumed. The Hanford sample differed from the national sample in the fraction residing in single-family homes, the fraction describing their residential surroundings as rural, and in ethnic makeup. The Hanford population displayed greater rates of participation than the national sample in three activities that have an obvious link to residence in a single-family dwelling: home repair involving digging, gardening, and other yard work, but differences were not explained entirely by residence type. The regional population also reported greater frequency of participation in multiple activities. In contrast, clothing choices among doers could not be distinguished between the two groups.
Importance of Vehicles in Topical Treatment of Fungal Infections

Topical drug therapies are commonly used to manage dermatologic diseases and their manifestations in the skin, hair, nails, and mucous membranes. Compared with systemic treatment, topical drug delivery provides 2 notable benefits in the management of skin diseases. In addition to delivering the active drug, a well-designed vehicle can have supportive effects on the skin, whereas a poorly designed vehicle can have detrimental effects. In many cases, the same active drug is available in several dosage forms, offering the prescriber the ability to tailor treatment to the patient's unique presentation and needs.
A Cluster Analysis of Point Mutation Cases of the P53 Gene

According to both tumour suppressor gene(P53) position point mutation data and their entropy data,a cluster analysis is carried out based on Ward's method.It turns out that positions with high mutation amount as well as high entropy values tend to be clustered into one class.A conclusion is drawn that alkali bases with high mutation probabilities for their instabilities are correlative to the areas with high entropy values.
Protein kinase C modulates natriuretic peptide receptors in astroglial cultures from rat brain.

We determined previously that astroglia cultured from newborn rat brain contain both guanylyl cyclase-coupled and atrial natriuretic peptide (ANP)-C natriuretic peptide receptors. Here, we investigated the effects of the protein kinase C (PKC) activator phorbol 12-myristate 13-acetate (PMA) on these receptor subtypes in cultured astroglia to understand the intracellular processes involved in the modulation of natriuretic peptide receptors in these cells. PMA (10 nM to 1 microM; 15 min to 24 h) treatment elicited a time- and concentration-dependent decrease in the numbers of 125I-labeled ANP specific binding sites, which was inhibited by the PKC antagonist staurosporine (500 nM). Furthermore, PMA (100 nM, 2 or 24 h) treatment elicited a significant decrease in the specific binding of 125I-des-Cys-Cys-ANP, an ANP-C receptor selective ligand. PMA (10 nM to 1 microM; 30 min) treatment also significantly decreased ANP (100 nM)-stimulated guanosine 3', 5'-cyclic monophosphate levels in cultured astroglia, an ef...
15-Hydroxyeicosatetraenoic acid-mediated potentiation of thrombin- induced platelet functions occurs via enhanced production of phosphoinositide-derived second messengers--sn-1,2-diacylglycerol and inositol-1,4,5-trisphosphate

We investigated whether biologically relevant concentrations of the mono-hydroxyeicosatetraenoic acids (mono-HETEs) modulate platelet functions. We report that 15-HETE, an eicosanoid produced by endothelial cells, granulocytes, and lymphocytes, potentiated platelet aggregation, nucleotide release, and elevation in intracellular calcium levels induced by a threshold concentration of thrombin (0.025 U/mL). Significant potentiation effects on these responses were observed at concentrations between 1 and 100 nmol/L. 15-HETE at these concentrations enhanced thrombin-induced platelet aggregation by 32% to 57%, nucleotide release by 40% to 65%, and elevation of intracellular calcium by 31% to 52% (P < .05 to .01). Both 12-HETE and 5-HETE, the structural isomers of 15-HETE, also potentiated thrombin-induced platelet aggregation and nucleotide release. While 12-HETE showed a small but significant effect at 100 pmol/L, 5-HETE had effects similar to those of 15-HETE at micromolar concentrations. To understand the mechanism of the HETE modulation of platelet functions, we studied the effect of 10 and 100 nmol/L 15-HETE on the production of sn-1,2-diacylglycerol (DAG) and inositol-1,4,5-trisphosphate (1,4,5-IP3). 15-HETE enhanced thrombin-induced production of DAG and 1,4,5-IP3 in a time- and concentration-dependent manner. 15-HETE also potentiated agonist-induced phosphorylation of the 47-Kd platelet protein. These studies demonstrate an important modulatory role for 15-HETE on platelet functions. Since this eicosanoid is elevated in pathologic states associated with platelet hyperfunction, including diabetes mellitus and atherosclerosis, an elucidation of its mechanism(s) of action appears relevant to our understanding of the genesis of atherothrombotic vascular disease.
Balancing Customer Service, Safety Issues, and Legal Requirements: It's All About Safety

As millions of passengers are carried on U.S. airlines each year, the airline industry is highly sensitive to costs and customer opinions when it comes to competing for customers. With an growing number of passengers flying, there is increasing concern among pilots and airline officials between balancing safety within the commercial aviation industry against customer service. Such concern has resulted in passengers threatening boycotts, the Department of Homeland Security (“DHS”) opining on security procedures conducted by the Transportation and Safety Administration (“TSA”), and TSA defending its current safety procedures. Such disconnect between customer satisfaction and the agencies involved in keeping our skies safe beckons the question: Can there be a balance between customer service and safety in the airline industry? The purpose of this paper paper is to analyze (1) specific Federal Aviation Regulations (“FARs”) in order to give context to the safety issues raised in this paper, (2) the right to privacy versus customer safety concerns, (3) various safety issues within the commercial aviation sector, (4) possible implications for practice arising from the review of safety and customer service issues, and (5) limitations and future research potential within the commercial aviation sector.
Antiphospholipid antibodies and fetal loss.

Clinicians recognized that pregnancy loss was associated with antiphospholipid antibodies (aPL) nearly 20 years ago, and by the mid-1980s, rheumatologists had formalized this clinical feature as one criterion of the antiphospholipid syndrome (APS). Harris listed “fetal loss” as the pregnancy loss criterion for APS in his 1987 proposal entitled The Syndrome of the Black Swan [1], implying that embryonic loss or neonatal death, would not qualify. The last decade has seen considerable debate regarding the nature of pregnancy loss associated with or attributable to aPL. The 1999 criteria proposed at the International Antiphospholipid Symposium in Sapporo, Japan probably reflect the best current consensus. These criteria include any of the following three different types of pregnancy loss as a clinical criterion for APS: (1) one or more unexplained deaths of a morphologically-normal fetus at or beyond the 10th week of gestation with normal fetal morphology documented by ultrasound or direct examination of the fetus, (2) one or more premature births of a morphologically-normal neonate at or before the 34th week of gestation because of severe pre-eclampsia or placental insufficiency, (3) three or more consecutive spontaneous abortions before the 10th week of gestation with maternal anatomic, hormonal abnormalities, and paternal and maternal chromosomal causes excluded [2]. In addition to clinical pregnancy loss, a number of investigators have found that infertility is associated with aPL. However, the clinical implications of this association are uncertain. The purpose of this chapter is to critically analyze the relationship between aPL and these obstetric problems, as well as to outline appropriate management plans when aPL are found in association with pregnancy loss.
Fluid First or Not So Fast: Ultrafiltration Rate and the ESRD Quality Incentive Program

Over the past decade, there has been tremendous emphasis on linking payment to performance. In 2008, the Medicare Improvements for Patients and Providers Act, in addition to directing the Centers for Medicare and Medicaid Services (CMS) to expand the dialysis bundle, legislated that payment will be
Impact of Type 2 Diabetes Threat Appraisal on Physical Activity and Nutrition Behaviors among Overweight and Obese College Students.

OBJECTIVE We examined the impact of threat appraisal (TA) on Type 2 diabetes (T2D)-related protective behaviors among high-risk college students. METHODS Using a Web-based survey, we collected data from 319 overweight or obese undergraduate students attending one of 4 Texas colleges/universities. Hierarchical multiple regression analyses determined the association between the outcome variable, fruits and vegetables (F&V) consumption and physical activity (PA), and TA. RESULTS Demographic characteristics were entered at step 1, explaining 7% of variance in F&V consumption and 6% in PA. After TA was entered in block 2, the total variance explained changed by only .008% for F&V consumption and .009% for PA. CONCLUSIONS TA did not predict T2D protective behaviors and reduced variability in the model. Being female, as well as having a T2D family history, was significantly associated with increased TA. Results can inform the planning, implementing, and evaluating of health promotion programs.
Hegel’s Theory of Religious Knowledge

Just as Augustine’s proof of the existence of God has been described as “neither an argument nor a series of arguments, but a complete metaphysics plus an ethics and a mysticism which crowns it,”1 so Hegel’s Lectures on the Proofs of the Existence of God are a microcosm of his systematic thought. Delivered in the summer semester of 1829, just two years before his death, and apparently intended for publication, they represent a mature statement of themes Hegel had worked on since Bern, Frankfurt, and Jena. Although they are by no means self sufficient, due to Hegel’s tendency to summarize at times what he had worked out in detail elsewhere and to the fact that only the cosmological argument gets discussed, they remain, properly supplemented, the best guide to a systematic statement of his theory of religious knowledge.
2,3,4,6-Tetra- O -benzyl-α-d-glucopyranose

Publisher Summary This chapter discusses the preparation of a partially benzylated aldopyranose by the synthesis of 2,3,4,6-tetra-O-benzyl-α- d -glucopyranose. While it has also been made from other glucopyranosides, commercial availability and inexpensiveness makes methyl α- d -glucopyranoside the starting material of choice. In preparation, methyl α- d -glucopyranoside is suspended in 150 ml of dry dioxane with 250 g of powdered potassium hydroxide, and the mixture is stirred and gently boiled under a reflux condenser while 318 ml of benzyl chloride is added in dropwise fashion over a period of ∼ 40 min. The residue is cooled and sufficient water is added to dissolve the crystalline mass, the methyl 2,3,4,6-tetra-O-benzyl-α- d -glucopyranoside then being extracted with ether.
Maternal attachment insecurity and poorer proficiency savoring memories with their children The mediating role of rumination

Relational savoring is the process of focusing one’s attention on the pleasurable parts of a relationship experience, and recent work has explored its relation to attachment styles. This study examined the relationship between attachment insecurity and the quality of responses to a relational savoring task among 63 mothers of children aged 9–12, testing the hypothesis that rumination mediated the relationship between greater attachment insecurity and lower quality savoring responses. Quality of savoring responses was measured two ways—on a macro level, via a global coding measure, as well as on a micro level, using word count analysis. Results indicated that greater attachment insecurity was related to lower quality relational savoring responses, and that in the case of attachment avoidance, maternal rumination mediated this relationship. These findings underscore the link between maternal attachment insecurity and poorer quality savoring, with preliminary cross-sectional findings pointing to rumination a...
Diabetes Screening in US Women With a History of Gestational Diabetes, National Health and Nutrition Examination Survey, 2007–2012

Introduction Women with a history of gestational diabetes mellitus (GDM) are at increased risk for developing type 2 diabetes mellitus. We examined individual, socioeconomic, and health care use characteristics of women with a history of GDM and the association of those characteristics with diabetes screening, and we estimated their rates of undiagnosed prediabetes and diabetes. Methods Using 3 cycles of the National Health and Nutrition Examination Survey (2007-2008, 2009-2010, and 2011-2012), we identified 284 women with a history of GDM who were eligible for diabetes screening. Screening status was defined by self-report of having had a blood test for diabetes within the prior 3 years. Undiagnosed prediabetes and diabetes were assessed by hemoglobin A1c measurement. Results Among women with a history of GDM, 67% reported diabetes screening within the prior 3 years. Weighted bivariate analyses showed screened women differed from unscreened women in measured body mass index (BMI) category (P = .01) and number of health visits in the prior year (P = .001). In multivariable analysis, screening was associated with a greater number of health visits in the prior year (1 visit vs 0 visits, adjusted odds ratio [AOR], 1.91; 95% confidence interval [CI], 0.71-5.18; 2 or 3 visits, AOR, 7.05; and ≥4 visits, AOR, 5.83). Overall, 24.4% (95% CI, 18.3%-31.7%) of women had undiagnosed prediabetes and 6.5% (95% CI, 3.7%-11.3%) had undiagnosed diabetes. Conclusion More health visits in the prior year was associated with receiving diabetes screening. Fewer opportunities for screening may delay early detection, clinical management, and prevention of diabetes. Prediabetes in women with a history of GDM may be underrecognized and inadequately treated.
The Electrophysiologic Effects of Acute Mitral Regurgitation in a Canine Model

Background Atrial fibrillation (AF) occurs in 30% of patients with mitral regurgitation referred for surgical intervention. However, the underlying mechanisms in this population are poorly understood. This study examined the effects of acute left atrial volume overload on atrial electrophysiology and the inducibility of AF. Methods Ten canines underwent insertion of an atrioventricular shunt between the left ventricle and left atrium. Shunt and aortic flows were calculated, and the shunt was titrated to a shunt fraction to 40% to 50% of cardiac output. An epicardial plaque with 250 bipolar electrodes was used to determine activation and refractory periods. Biatrial pressures and volumes, conduction times, and atrial fibrillation inducibility were recorded. Data were collected at baseline and 20 minutes after shunt opening and closure. Results Mean shunt flow was 1.3 ± 0.5 L/min with a shunt fraction of 43% ± 6% simulating moderate to severe mitral regurgitation. Compared with baseline, left atrial volumes and maximum pressures increased by 27% and 29%, respectively, after shunt opening. Biatrial effective refractory periods did not change significantly after shunt opening or closure. Conduction times increased by 9% with shunt opening and returned to baseline after closure. AF duration or inducibility did not change with shunt opening. Conclusions This canine model of mitral regurgitation demonstrated that acute left atrial volume overload did not increase the inducibility of atrial arrhythmias in contrast with experimental and clinical findings of chronic left atrial volume overload. This suggests that the substrates for AF in patients with mitral regurgitation are a result of chronic remodeling.
Rapid response to a college outbreak of meningococcal serogroup B disease: Nation's first widespread use of bivalent rLP2086 vaccine.

ABSTRACTObjective: To outline the reasoning behind use of bivalent rLP2086 in a Rhode Island college meningococcal B disease outbreak, highlighting the timeline from outbreak declaration to vaccination clinic, emphasizing that these two time points are <3 days apart. Participants: Staff, faculty, and students at College X eligible for vaccination. Methods: An outbreak response was initiated, advantages/disadvantages of available MenB vaccines were discussed, and a vaccination clinic was coordinated. Results: Bivalent rLP2086 was chosen as the vaccination intervention. We achieved a 94% coverage rate for the first dose. To date, this intervention has prevented further cases of Neisseria meningitidis serogroup B disease at College X. Conclusions: The close, efficient collaboration of public health stakeholders and College X led 94% of the eligible population to be safely vaccinated with at least one dose of bivalent rLP2086. This outbreak marked the first time bivalent rLP2086 was effectively used as an int...
ALMAS EXTERIORES. UMA REFLEXÃO SOBRE MODA E ESCRITURA EM MACHADO DE ASSIS

Os elementos da indumentaria em Machado ultrapassam o mero acessorio para assumirem um manancial de significacoes que os atraem para o centro mesmo da construcao da narrativa. Qual a funcao dos qualia ? Sao tais elementos contingentes, acessorios ou necessarios?
Characteristics of Laws Requiring Physicians to Report Patient Information for Public Health Surveillance: Notable Patterns from a Nevada Case Study

Laws across the globe require healthcare providers to disclose patient health information to public health entities for surveillance and intervention purposes. Physicians play a unique role in such mandatory reporting regimes. However, research reveals consistent under-reporting and points to limited knowledge of mandates, perceived burdens of reporting, misaligned incentives and penalties, and a lack of streamlined processes as significant reporting barriers. These barriers suggest that how legal mandates are structured may impact compliance; yet little research systematically examines their characteristics. Law-based reporting requirements differ across jurisdictions. Thus, we conducted a case study in the U.S. State of Nevada to characterize its physician mandatory reporting laws using legal mapping methodology. Nevada is a useful case study because it has few local jurisdictions and its legislature meets biennially. First, we searched key terms to find relevant state mandates and screened them using inclusion criteria. We then scanned near included provisions for additional requirements and incorporated requirements known a priori. We also searched relevant local regulations. Next, we analyzed all included provisions. Our findings indicate wide, intra-jurisdictional variation in reporting requirements across conditions. Variability extends to physician discretion, information reported, timing, recipient agencies, reporting processes, and implications of non-compliance. Local-level variation adds further complexity. Some relevant state requirements apply only to physicians and nearly one-third were absent from our searches. Our findings support exploring the hypothesis that reporting requirements' characteristics may impact compliance and call for empirically testing such relationships to enhance compliance and public health surveillance and intervention efforts.
Spread of Employee Engagement in a Large Organizational Network: A Longitudinal Analysis

Behavioral statescan be transferred to others, leading people to behave in ways similar to those around them. Can this phenomenon of behavioral contagion be seen in the workplace? Using employees' organizational social media data and their workplace hierarchical network structure, we studied contagion across a large multinational corporation, focusing on an important workplace behavior - employee engagement. We measured employees' engagement based on their word choice in organizational social media, and we applied a longitudinal statistical technique which controls for homophily, employees' traits and prior expressions of engagement. We found that engagement and disengagement spread from one employee to another with direct peers exerting the strongest influence. While engagement-spread was more powerful laterally among people at the same organizational level, disengagement-spread followed the vertical managerial chain. Further, we found that disengaged co-workers exerted a stronger influence on employee's future engagement compared to the engaged co-workers. Our results suggest the need for organizations to sense and address workplace disengagement promptly. Moreover, our findings offer opportunities for using workplace interventions to promote engagement and mitigate disengagement.
Thermal transport across solid-solid interfaces enhanced by pre-interface isotope-phonon scattering

Thermal transport across solid interfaces can play critical roles in the thermal management of electronics. In this letter, we use non-equilibrium molecular dynamics simulations to investigate the isotope effect on the thermal transport across SiC/GaN interfaces. It is found that engineered isotopes (e.g., 10% 15N or 71Ga) in the GaN layer can increase the interfacial thermal conductance compared to the isotopically pure case by as much as 23%. Different isotope doping features, such as the isotope concentration, skin depth of the isotope region, and its distance from the interface, are investigated, and all of them lead to increases in thermal conductance. Studies of spectral temperatures of phonon modes indicate that interfacial thermal transport due to low-frequency phonons (< 20 THz) is enhanced after isotopes are introduced. These results suggest that the enhanced thermal conductance is related to the isotope-phonon scattering, which facilitates the redistribution of phonon energy among different mod...
Ambulatory Clinic Exam Room Design with respect to Computing Devices: A Laboratory Simulation Study

OCCUPATIONAL APPLICATIONS When comparing a typical exam room layout to the Department of Veterans Affairs (VA's) new exam room design, with respect to the exam room computing, primary care provider...
The Treatment of Convergence Insufficiency

Idiopathic convergence insufficiency is characterized by in-adequate fusional convergence, causing a variety of asthenopic symptoms which occur during the act of reading.Orthoptic therapy to increa...
Dynamics of coalition formation in combinatorial trading

This paper studies the dynamics of agent mediated combinatorial trading at the macroscopic level. The combinatorial marketplace consists of a retailer who wishes to sell bundles of items, and a large number of agents with different purchasing goals. These agents dynamically form coalitions to exploit the benefits of grouping based on their complementary needs. A novel physics based dynamic equation is proposed to capture the essence of the movements of agents among different sized coalitions. Simulation experiments are performed to study the global behavior of the agents and the effectiveness of the agent mediated combinatorial trading.
Capillary Wall Permeability Effects in Perfused Capillary-Tissue Structures

In a series of previous papers [1,2,3,5 and 8], we have discussed models that have been adapted to represent, among other experiments, the perfused heart preparation shown in figure 1. These papers have corrected previous representation errors and have discussed computational difficulties encountered by others using mathematical solutions of these models. However, it was found that the model representations as used by Krogh [6], and later modified by Blum [7] were not completely adequate to represent the data as determined by the experimental design in [4].
T-Cell Antigen Receptor

The T-cell antigen receptor (TCR) is a complex, multimolecular structure expressed by T cells, which is responsible for recognizing self and foreign antigens presented in the context of major histocompatibility (MHC) molecules on the surface of antigen presenting cells (APCs). Expression of the TCR requires the assembly of all six TCR:CD3 proteins and is required for T-cell development, activation, and signaling. These processes are critical for maintaining immune homeostasis and regulating the immune response.
Why Marr’s Theory of Vision is not Anti-Individualist

Tyler Burge has argued that Marr’s theory of vision is anti-individualist.1 If correct, his argument would show that visual states, as they are characterized in that theory, do not supervene locally on inner non-intentional states of the subject and, thus, that individualism is false in Marr’s theory. As it is well known, according to mental local supervenience, if two psychological subjects share all their non-intentional inner physical properties - that is if they are so-called physical twins - then they also share all their mental properties; or, in other words, if two subjects are identical in all inner physical respects, then they cannot fail to be identical in all mental respects. Burge’s argument rests essentially on two general assumptions. First, it is assumed that on Marr’s theory the physical environment imposes constraints on the individuation of representational primitives used in what is called the theory of computation.2 Secondly, it must be possible to produce a thought experiment showing that physical twins, or doppelgangers, inhabiting relevantly different physical environments would have visual states carrying different informational content. It is the second of these two general assumptions that I want to question.
Systemic lupus erythematosus. Antibodies to DNA, DNA-binding proteins, and histones

Pathogenic autoantibodies to DNA are frequently associated with autoantibodies to chromatin-associated proteins such as histones or the Ku (p70/p80) antigens. In view of the increasing evidence that autoantibody production is antigen-driven, and because DNA is packaged with proteins in the cell, we suggest that anti-DNA antibodies may arise in response to DNA-protein complexes rather than naked DNA. Recent studies of the specificities of autoantibodies directed against the components of nucleosomes and transcriptional complexes are consistent with this hypothesis. The possible clinical significance of immune recognition of various types of chromatin complexes in autoimmune disease is discussed.
Photocurable coatings prepared by emulsion polymerization present chelating properties.

Abstract Herein, we present a method to synthesize a photocurable metal chelating copolymer coating via emulsion polymerization to enable a facile coat/cure preparation of metal chelating materials. The copolymer coating was a poly(n-butyl acrylate) based polymer (79 mol %) synthesized by emulsion polymerization, with iminodiacetic acid (2 mol %) and benzophenone moieties (19 mol %) to impart metal chelating and photocrosslinking properties, respectively. The copolymer was applied onto polypropylene films and was photocured (365 nm, 225 mW/cm2, 180 s) to produce metal chelating film. The resulting metal chelating film had activity towards Fe3+ by chelating 10.9 ± 1.9 nmol/cm 2 , 47.9 ± 5.3 nmol/cm2, and 156.0 ± 13.8 nmol/cm2 of Fe3+ at pH 3.0, pH 4.0, and pH 5.0, respectively. The metal chelating film controlled transition metal induced ascorbic acid degradation by extending half-life of ascorbic acid degradation from 6 days to 20 days at pH 3.0, and from 3 days to 6 days at pH 5.0, demonstrating its potential as an antioxidant active packaging material. Despite the introduction of polar iminodiacetic acid chelating moieties, the poly(n-butyl acrylate) based coatings retained low surface energies (24.0 mN/m) necessary to mitigate fouling and enable product release in packaging applications. This work overcomes a major knowledge gap in the area of functional coatings, by demonstrating a method by which critical properties such as control of surface energy, retention of mechanical properties, and scalability are integrated into the structure of a functional coating. The photocurable polymer coatings as reported here enable scalable production of active materials with metal chelating functionality, with applications in water treatment, trace metal detection, protein purification, and active packaging.
Impact of specimen configuration and characteristics on illinois flexibility index

The Illinois Department of Transportation adopted the Illinois Flexibility Index Test (I-FIT) to evaluate the cracking vulnerability of asphalt concrete (AC) mixtures that was often shown to increa...
Racimo, la novela rizoma de Diego Zúñiga

Este articulo propone una lectura de la novela Racimo (2014) de Diego Zuniga desde los postulados teoricos desarrollados por Gilles Deleuze y Felix Guattari. El objetivo de lapropuesta es indagar los alcances del juego de palabras “racimo-rizoma” en la construcciony disposicion de acontecimientos narrados, para evidenciar que la novela funciona comorizoma. El montaje de elementos dispares rompe el orden convencional y traza variadaslineas de fuga que transgreden la verdad instituida. Se aborda ademas el imaginario deldesierto y del mar chileno, a partir de las definiciones conceptuales entregadas por JeanJacques Wunnenburger.
Building a Classification Model Using Affinity Propagation

Regular classification of data includes a training set and test set. For example for Naive Bayes, Artificial Neural Networks, and Support Vector Machines, each classifier employs the whole training set to train itself. This study will explore the possibility of using a condensed form of the training set in order to get a comparable classification accuracy. The technique we explored in this study will use a clustering algorithm to explore how the data can be compressed. For example, is it possible to represent 50 records as a single record? Can this single record train a classifier as similarly to using all 50 records? This thesis aims to explore the idea of how we can achieve data compression through clustering, what are the concepts that extract the qualities of a compressed dataset, and how to check the information gain to ensure the integrity and quality of the compression algorithm. This study will explore compression through Affinity Propagation using categorical data, exploring entropy within cluster sets to calculate integrity and quality, and testing the compressed dataset with a classifier using Cosine Similarity against the uncompressed dataset.
Effect of change in practice of timing of Elective Deliveries in a Hospital based Obstetric Unit on Morbidity and Mortality of Infants

Background: In November 2013, The American College of Obstetricians and Gynecologists (ACOG) Committee on Obstetric Practice Society for Maternal-Fetal Medicine officially released new guidelines thereby replacing the word “term pregnancy” with the designations “early term” (37 0/7 weeks of gestation through 38 6/7 weeks of gestation) and “full term” (39 0/7 weeks of gestation through 40 6/7 weeks of gestation). Owing to this new guideline, all elective deliveries were performed at 39 weeks gestation instead of 37 weeks starting mid 2013 in the Obstetrics Unit of MetroHealth Medical Center. Aims: To …