cssi/SciSciGPT-SciSciNet huggingface dataset:
Long-term cocaine use is related to cardiac diastolic dysfunction in an African–American population in Baltimore, Maryland

Abstract Background: Only limited studies have been done on the effects of long-term cocaine use on the human heart, and the results remain controversial. In this study, we examined and compared the diastolic function of non-cocaine users and chronic cocaine users to reveal the impact of long-term cocaine use on the human heart. Methods: Two-dimensional echocardiogram and pulsed Doppler transmitral blood flow pattern were obtained from 138 recruited study participants with different cocaine histories. The indices of cardiac structure and function were measured from the echocardiogram of each participant. Student's t -test was used to compare the average echocardiographic measurements of the non-cocaine user group and the cocaine user group. Multivariate regression analysis was deployed to eliminate the effects of age, gender, blood pressure, and HIV infection on the functional measurements of the two groups. Results: The cocaine user group had a significantly longer average deceleration time than did the non-cocaine user group (208.1±38.2 vs. 167.5±39.1 ms, P P =0.001). Cocaine users in this study were approximately five times more likely to have an elongated deceleration time (>200 ms) than were non-users (OR, 4.799; 95% CI, 1.000–23.044; P =0.05). No significant differences were observed in the other measured diastolic functional parameters, such as isovolumic ventricular relaxation time, E wave, A wave, and E/A ratio. Conclusions: Long-term cocaine use is linked to decline in diastolic function.
A Fuzzy Logic Algorithm to Assign Confidence Levels to Heart and Respiratory Rate Time Series

We have developed a fuzzy logic-based algorithm to qualify the reliability of heart rate (HR) and respiratory rate (RR) vital-sign time-series data by assigning a confidence level to the data points while they are measured as a continuous data stream. The algorithm's membership functions are derived from physiology-based performance limits and mass-assignment-based data-driven characteristics of the signals. The assigned confidence levels are based on the reliability of each HR and RR measurement as well as the relationship between them. The algorithm was tested on HR and RR data collected from subjects undertaking a range of physical activities, and it showed acceptable performance in detecting four types of faults that result in low-confidence data points (receiver operating characteristic areas under the curve ranged from 0.67 (SD 0.04) to 0.83 (SD 0.03), mean and standard deviation (SD) over all faults). The algorithm is sensitive to noise in the raw HR and RR data and will flag many data points as low confidence if the data are noisy; prior processing of the data to reduce noise allows identification of only the most substantial faults. Depending on how HR and RR data are processed, the algorithm can be applied as a tool to evaluate sensor performance or to qualify HR and RR time-series data in terms of their reliability before use in automated decision-assist systems.
Controllability Characterizations of Leader-Based Swarm Interactions

In this paper, we investigate what role the network topology plays when controlling a network of mobile robots. This is a question of key importance in the emerging area of human-swarm interaction and we approach this question by letting a human user inject control signals at a single leader-node, which are then propagated throughout the network. Based on a user study, it is found that some topologies are more amenable to human control than others, which can be interpreted in terms of the rank of the controllability matrix of the underlying network dynamics, as well as, measures of node centrality on the leader of the network.
Towards a Google Glass Based Head Control Communication System for People with Disabilities

We have developed Noggin and Glass Gab, two Google Glass based systems to allow people with disabilities to choose Yes or No and spell out messages just by moving their head. Our goal is to allow people who cannot speak and do not have reliable control of their hands to communicate just with head movements. The advantage of using Google Glass is that the user, perhaps in a wheelchair, does not need a notebook computer or tablet computer. The system displays a pointer on the Google Glass screen and Yes and No buttons (Noggin) or an onscreen keyboard (Glass Gab). The user moves the pointer by head movement. Selection is made using dwell time, by having the pointer dwell over the buttons or letters for a second. The user can have Google Glass speak the message. Head motion is detected using the three axis gyroscope built into Glass.
Women's Rights in International Law: Legitimacy, Persuasion and Structuration

The widespread adoption of the Convention for the Elimination of All Discrimination Against Women (CEDAW) represents a puzzle. The treaty cannot be described as being in the interests of any state; it commits countries to a program of radical social change, requiring them to instantiate domestically norms that no country actually practices – and yet it is also one of the most ratified UN treaties. Even from the perspectives of Constructivism and the English School, the two approaches to international relations most promising for explaining cooperation in the absence of strategic or economic interests, the treaty is puzzling. No national community collectively holds the norms expressed in the treaty, and so it is difficult to invoke the English School concept of Solidarism; the only group for which the norms expressed in CEDAW can be said to form a Constructivist constitutive identity are a relatively small group of secular, educated women. We invoke Giddens' notion of structuration to explain how a small network of secular Western women, many of them diplomats, were able to work the structures of international diplomacy to create institutions that furthered the ideals they championed. We build on a synthesis of English School and Constructivist approaches to norms developed in Englehart 2010 to show how social interactions between individuals can be leveraged to create behaviors that lead to trans-national structures.
Direct compensation of lift-off oscillation effect in magnetic impedance–based damage detection

Owing to its magneto-mechanical coupling characteristics, a magnetic transducer such as the electro-magnetic acoustic transducer can excite a metallic structure by means of the Lorenz force, and its electrical impedance is actually directly related to the mechanical impedance of the structure. Therefore, the change in electrical impedance measured can be used as an indicator of damage occurrence. As such, this type of magnetic transducer can be used in impedance-based structural damage detection, which features a non-contact advantage. Nevertheless, one key issue is that the coupling between the magnetic transducer and the structure monitored is strongly influenced by the lift-off distance (i.e. the distance from the transducer to the structure) which oscillates as the structure is oftentimes subject to oscillation/movement due to environment disturbance. In this research, we propose a new data analysis approach of transformed impedance that is immune to the lift-off distance oscillation during measuremen...
Double-slit interference effect in electron emission from H 2 + exposed to x-ray radiation

We consider the photoionization of the hydrogen molecular ion exposed to x-ray radiation for photon energies up to 500 eV in the fixed-nuclei approximation. The temporal development of the system is described by a fully ab initio time-dependent grid-based approach in prolate spheroidal coordinates. At sufficently high photon energies, the angular distributions of the electron ejected from the two-center diatomic target resemble the classical double-slit-like interference pattern more closely when the molecular axis and the linear laser polarization direction are perpendicular to each other than in the parallel geometry. Both the preferable emission modes and the confinement effect (in the parallel geometry) of the photoelectron also map out in the time evolution of the wave packets. The validity of a simple plane-wave model is analyzed by comparing its predictions with those from our accurate ab initio calculations.
Comparison study of diffraction based overlay and image based overlay measurements on programmed overlay errors

In this paper we will present the comparison study of these two methods on programmed errors of critical layers of 14nm technology node. Programmed OVL errors were made on certain fields during the exposure. Full coverage OVL measurements were performed using both IBO and DBO. Linear, HOPC and iHOPC modeling has been done from non-programmed fields. Then modeling has been subtracted from these certain programmed fields, and Reticle contribution was also calculated and subtracted. In this study, metrology measurement accuracy and stability can be feasible and more accurate OVL control is enabled by selecting better OVL measurement techniques.
Exchange Narrowing of d Bands in Antiferromagnets

A semiphenomenological Hamiltonian based on the generalized Hartree-Fock equations for a two-component spinor is developed which describes the interaction of an electron in the $d$ band with the spin waves of a ferromagnet. Solutions to the effective Hamiltonian are examined in the tight-binding approximation using a self-consistent separation of the electron and spin-wave variables. The dynamic interaction of the electron with the spin waves gives rise to a band-narrowing factor $\mathrm{exp}(\ensuremath{-}\ensuremath{\zeta})$ analogous to that obtained by Yamashita and Kurosawa for the polaron. $\ensuremath{\zeta}$ increases with temperature and estimates show that it may be on the order of unity for a typical ferromagnet at low temperatures.
Oxidation of free fatty acids by skeletal muscle during rest and electrical stimulation in control and diabetic dogs.

SummaryThe uptake and oxidation of FFA by skeletal muscle were studied in anesthetized, control dogs during rest, electrical stimulation, recovery, and DNP administration. Similar studies were also conducted in diabetic animals during rest, stimulation, and recovery. During rest, skeletal muscle removed about 40% of the labeled FFA and oxidized 36% of the removed amount. During skeletal muscle stimulation, the oxidation of FFA increased. During the recovery period, FFA oxidation was very low and accounted for about 12% of the uptake. The DNP also increased FFA oxidation. Both the uptake and oxidation of FFA by skeletal muscle were elevated in diabetic dogs and a significant uptake of β-hydroxybutyrate was also noted. A further increase of FFA oxidation occurred during stimulation. During recovery, only 7% of the removed FFA was oxidized and glucose uptake was high.
Commentary on: Postoperative clitoral hood deformity after labiaplasty.

Case reports usually do not merit commentary, but the primary topic raised by Hamori1 in this publication—namely, the consequences of failure to appreciate and appropriately address clitoral hood skin redundancy at the time of labia minora reduction—indeed warrants discussion. As labiaplasty has grown in popularity, the frequency of postoperative clitoral hood “deformity” complaints has, in my opinion, also increased. In my revision experience, clitoral hood skin redundancy is the most common reason women seek corrective surgery after labia minora reduction. Reporting 2 revision cases, Hamori highlights this often overlooked problem. Greater awareness is important as more surgeons who may be inexperienced in female genital cosmetic surgery increasingly market and perform labiaplasty procedures. Labia minora reduction is viewed as a simple procedure by many plastic surgeons and gynecologists. In some cases, it is. Unfortunately, many women possess complex genital anatomic variations, including …
A genomic approach to myoblast fusion in Drosophila

We have developed an integrated genetic, genomic and computational approach to identify and characterize genes involved in myoblast fusion in Drosophila. We first used fluorescence activated cell sorting to purify mesodermal cells both from wild-type embryos and from twelve variant genotypes in which muscle development is perturbed in known ways. Then, we obtained gene expression profiles for the purified cells by hybridizing isolated mesodermal RNA to Affymetrix GeneChip arrays. These data were subsequently compounded into a statistical meta-analysis that predicts myoblast subtype-specific gene expression signatures that were later validated by in situ hybridization experiments. Finally, we analyzed the myogenic functions of a subset of these myoblast genes using a double-stranded RNA interference assay in living embryos expressing green fluorescent protein under control of a muscle-specific promoter. This experimental strategy led to the identification of several previously uncharacterized genes required for myoblast fusion in Drosophila.
Does quitting smoking make a difference among newly diagnosed head and neck cancer patients

Introduction To determine if smoking after a cancer diagnosis makes a difference in mortality among newly diagnosed head and neck cancer patients. Methods Longitudinal data were collected from newly diagnosed head and neck cancer patients with a median follow-up time of 1627 days (N = 590). Mortality was censored at 8 years or September 1, 2011, whichever came first. Based on smoking status, all patients were categorized into four groups: continuing smokers, quitters, former smokers, or never-smokers. A broad range of covariates were included in the analyses. Kaplan-Meier curves, bivariate and multivariate Cox proportional hazards models were constructed. Results Eight-year overall mortality and cancer-specific mortality were 40.5% (239/590) and 25.4% (150/590), respectively. Smoking status after a cancer diagnosis predicted overall mortality and cancer-specific mortality. Compared to never-smokers, continuing smokers had the highest hazard ratio (HR) of dying from all causes (HR = 2.71, 95% confidence interval [CI] = 1.48-4.98). Those who smoked at diagnosis, but quit and did not relapse-quitters-had an improved hazard ratio of dying (HR = 2.38, 95% CI = 1.29-4.36) and former smokers at diagnosis with no relapse after diagnosis-former smokers-had the lowest hazard ratio of dying from all causes (HR = 1.68, 95% CI = 1.12-2.56). Similarly, quitters had a slightly higher hazard ratio of dying from cancer-specific reasons (HR = 2.38, 95% CI = 1.13-5.01) than never-smokers, which was similar to current smokers (HR = 2.07, 95% CI = 0.96-4.47), followed by former smokers (HR = 1.70, 95% CI = 1.00-2.89). Conclusions Compared to never-smokers, continuing smokers have the highest HR of overall mortality followed by quitters and former smokers, which indicates that smoking cessation, even after a cancer diagnosis, may improve overall mortality among newly diagnosed head and neck cancer patients. Health care providers should consider incorporating smoking cessation interventions into standard cancer treatment to improve survival among this population. Implications Using prospective observational longitudinal data from 590 head and neck cancer patients, this study showed that continuing smokers have the highest overall mortality relative to never-smokers, which indicates that smoking cessation, even after a cancer diagnosis, may have beneficial effects on long-term overall mortality. Health care providers should consider incorporating smoking cessation interventions into standard cancer treatment to improve survival among this population.
Mental Tasking and Caloric-Induced Vestibular Nystagmus Utilizing Videonystagmography

Purpose The purpose of this study was to quantify the effects of mental tasking on measures of the caloric vestibulo-ocular reflex utilizing videonystagmography as the measurement technique. Method...
Climate Prediction and Agriculture: Lessons Learned and Future Challenges from an Agricultural Development Perspective

This opportunity to react to contemporary work on climate prediction in agriculture is a welcome one for someone who occasionally and mainly youthfully dabbled in the influence of climate in agriculture (e.g. Anderson 1970, 1979, 1981, 1985, 1991; Anderson and Dillon 1988a; Anderson and Hardaker 1973; Anderson and Hazell 1989), who was excited at the prospects for informative predictions (e.g. Byerlee and Anderson 1969, 1982; Anderson and Dillon 1992) but who has long since been far too remote from the action. Accordingly, to jump across the decades of progress, the point of departure taken here is the opening keynote address by Sivakumar (2006), in which the state of the art is succinctly summarized, albeit in a way that emphasizes the possibilities in a guardedly positively manner. Intriguingly, and seemingly properly in the view of this observer, he uses cautious words such as “could help” when charting the situations where climate forecasting efforts are intended to assist farmers and other agricultural managers in their decisions in the face of climatic uncertainty.
Cardiac T-Tubule Microanatomy and Function

Unique to striated muscle cells, transverse tubules (t-tubules) are membrane organelles that consist of sarcolemma penetrating into the myocyte interior, forming a highly branched and interconnected network. Mature t-tubule networks are found in mammalian ventricular cardiomyocytes, with the transverse components of t-tubules occurring near sarcomeric z-discs. Cardiac t-tubules contain membrane microdomains enriched with ion channels and signaling molecules. The microdomains serve as key signaling hubs in regulation of cardiomyocyte function. Dyad microdomains formed at the junctional contact between t-tubule membrane and neighboring sarcoplasmic reticulum are critical in calcium signaling and excitation-contraction coupling necessary for beat-to-beat heart contraction. In this review, we provide an overview of the current knowledge in gross morphology and structure, membrane and protein composition, and function of the cardiac t-tubule network. We also review in detail current knowledge on the formation of functional membrane subdomains within t-tubules, with a particular focus on the cardiac dyad microdomain. Lastly, we discuss the dynamic nature of t-tubules including membrane turnover, trafficking of transmembrane proteins, and the life cycles of membrane subdomains such as the cardiac BIN1-microdomain, as well as t-tubule remodeling and alteration in diseased hearts. Understanding cardiac t-tubule biology in normal and failing hearts is providing novel diagnostic and therapeutic opportunities to better treat patients with failing hearts.
Development of solid SEDDS, VI: Effect of precoating of Neusilin® US2 with PVP on drug release from adsorbed self-emulsifying lipid-based formulations

Abstract Adsorption of lipid-based formulations, which are usually liquid, onto silicas has been extensively investigated in the past decade to convert them into solid dosage forms. There are conflicting reports on the ability of commercially available porous silicas, like Neusilin® US2, to release lipid formulations completely, especially after long-term storage. In this study, the release of a model drug, probucol, from different formulations of medium chain lipids and a surfactant, Kolliphor EL (Cremophor EL) or polysorbate 80, were studied after adsorbing them onto Neusilin® US2. Complete drug release (> 80%) was obtained from all formulations on Day 1; however, the extent of drug release decreased progressively with time. The decrease was dependent on the relative hydrophilicity of the formulations. The maximum decrease ( 80%) even after 6 months of storage.
Disentangling The Effects Of Student Attitudes and Behaviors On Academic Performance

The interplay among motivation, ability, attitudes, behaviors, homework, and learning is unclear from previous research. We analyze data collected from 687 students enrolled in seven economics courses. A model explaining homework and exam scores is estimated, and separate analyses of ability and motivation groups are conducted. We find that motivation and ability explain variation in both homework and exam scores. Attitudes and behaviors, such as procrastination and working with others directly, affect homework score, but not exam score. These effects are not the same within all motivation and ability groups. Given that homework is the strongest predictor of exam score, we conclude that graded homework is beneficial to learning, and attitudes and behaviors related to homework may have an indirect benefit for exam performance. Suggestions are made as to how homework and course design might be managed to help students at different ability and motivational levels maximize learning.
Metabolism of barbiturates in man

Barbiturate effeets in man are limited by various proeesses. These include redistribution of unehanged drug within the body, development of toleranee, renal exeretion, and metabolie transformation. Biotransformation of barbiturates is mediated primarily by mierosomal enzyme systems residing in the liver. Yet, beeause of the abundant reserve eapacity of this organ, barbiturates need rwt be withheld from patients with liver disease unless the aeeompanying funetional impairment is extreme. Side ehain oxidation is the major meehanism of inactivation of barbiturates in vivo; 5-dealkylation has also been deseribed. Ring cleavage, of theoretieal import, has still to be demonstrated in man. The products of other metabolie pathways sueh as N-demethylation, desulfuration and (if verified) N-methylation retain pharmacologic activity; these are not mechanisms for termination of barbiturate effect. Barbiturates may conveniently be divided into two groups according to whether their rate of metabolism is measured in days (long- and medium-acting barbiturates) or in hours (anesthetie and short-acting barbiturates). None is metabolized rapidly. Aeeeleration of mierosomal enzyme activity indueed by drugs and other eompounds, amply documented in animals, may ultimately prove a signifieant factor in barbiturate metabolism in man, whose drug history is often complex.
The conundrum between political and sectoral decentralizations: The case of Cameroon

In recent years, alongside implementation of ‘traditional’ decentralisation policies, sectoral decentralisation experiments in natural resources management have taken place worldwide mainly under the justification of improving resource conservation and rural development. In the Congo basin, for instance, the epicentre of Africa's tropical rainforests, Cameroon has been engaged in these dual processes of devolution of power to municipalities and municipal involvement in the forestry sector. Drawing on the case of the first municipal forest governance experiment in Cameroon, the paper argues that the lack of co-ordination between the political and sectoral decentralisations is undermining the foundation for effective, democratic and accountable municipal and environmental governance. The case provides useful policy recommendations for donors supporting the global emergence of municipal governments’ capacity. This article is protected by copyright. All rights reserved.
Ascending Pathways Transmitting Nociceptive Information in Animals

The responses of animals to noxious stimuli are comparable to those of humans and thus include both sensory and motor reactions (37). Furthermore the sensory component of the pain response is divisible into sensory-discriminative and motivational-affective aspects (61). This chapter emphasizes the ascending tracts of the spinal cord that are likely to play an important role in the sensory responses to noxious stimuli in animals, especially in common laboratory animals such as the monkey, cat, and rat.
Rest and exercise hemodynamics following aortic valve replacement. A comparison between 19 and 21 mm Ionescu-Shiley pericardial and Carpentier-Edwards porcine valves.

When aortic valve replacement is performed in a patient with a small anulus, significant obstruction of the left ventricular outflow tract may remain. Most prostheses are obstructive in the smaller sizes, and enlargement of the aortic anulus may be required to allow placement of a larger valve. To evaluate the hemodynamic performance of two commonly used tissue prostheses, the Ionescu-Shiley pericardial and Carpentier-Edwards porcine valves, 22 patients with either the 19 or 21 mm size were electively studied at rest and after exercise at a mean of 15 months after operation. The resting mean transvalvular gradient for 19 mm Ionescu-Shiley pericardial valves (n = 7), 10.6 ± 9.2 mm Hg, was significantly lower than that for 19 mm Carpentier-Edwards valves (n = 3), 33.3 ±2.1 mm Hg, p
Democracy by Design

Renewing US democracy will require an active and deliberative public, people who can work together to address pressing social and political problems. To engage effectively Americans need an understanding of how American democracy works, its foundations and the complex and sometimes changing dimensions to those foundations. Advocates for increasing active and deliberative citizen engagement need to work with reformers in different areas of democracy’s ecological system, integrating public engagement with reform efforts in justice and equal opportunity, knowledge and information development, and government integrity.
Low Carbon Pathways

The climate debate for India encompasses issues other than just energy choices and energy efficiency. It is an integrated puzzle around lifestyle choices, aspirations of 1.2 billion people, and informed actions on water, air quality, and climate front. Further, in the wake of the COP-21 talks at Paris and the already announced US-China agreement on peaking of GHG emissions, India’s approach to climate mitigation and adaptation is keenly watched in the climate policy space globally. This paper outlines one such approach using the India Energy Security Scenarios-2047 tool of the NITI Aayog and explores India’s emissions trajectory till the year 2047 if the past trends continue and the trajectory if low carbon energy choices are made. Further, the study states the interventions in the demand and the supply sector which can make this transition feasible. However, such a transition will not happen without making investments in technologies, programs and infrastructure and hence a likely estimate of the quantum of investments is also estimated till the year 2047.
Prospective Evaluation of Urodynamic Utility in a Subspecialty Tertiary Practice.

Objective To prospectively evaluated the utility of urodynamic evaluations (UDS) ordered in a tertiary referral center as part of a quality improvement project. Methods Patients with UDS ordered by 3 subspecialty physicians were included. Physicians were surveyed when ordering UDS and at the post-UDS clinic visit to assess indications for UDS, pre- and post-UDS diagnosis, treatment plan, confidence level, and perceived helpfulness of UDS. UDS trained nurses conducting studies were surveyed on patient reported reproducibility of their symptoms and perceived difficulty of UDS. Results From April 2017 to October 2017, 127 UDS were included of which 102 met study criteria. UDS were done for neurogenic (23%) and non-neurogenic lower urinary tract symptoms (76%). The majority were conducted for incontinence evaluation (79%), or after prior lower urinary tract surgery (33%). UDS nurses reported 90% of UDS fully or partially reproduced patient symptoms. Nurses found 18% of UDS difficult due to catheter malfunctions, physical limitations, and communication abilities. Post-UDS, providers found 97% of UDS interpretable. UDS resulted in a change in treatment plan in 78% of patients. On a Likert scale, mean pre-UDS confidence level was 2.9 ± 0.8 (range 0-5). This increased to 4.1 ± 0.6 post-UDS with 76% of evaluations having a change of at least 1 point. Conclusion UDS in a tertiary referral center result in change in patient treatment plans over three-fourths of the time with high rates of interpretability.
An Interdiction Detection and Prevention System (IDPS) for Anti-Autonomy Attack Repulsion

Unmanned vehicles, such as spacecraft and aircraft, are potentially susceptible to attacks that seek to compromise their operations or cause damage or destruction through the use of attacks that target their autonomous decision making capabilities. These attacks may be used for both offensive and defensive purposes. So-called ‘anti-drone’ or ‘anti-autonomy’ technologies are gaining attention in the aviation sector as a way to prevent UAV entrance into controlled areas or combat a UAV attack. Like with most warfighting technologies, superiority requires both a way to assure your own attacks while denying enemy attack capabilities. Thus, a mechanism for effective prevention of attacks that seek to exploit vulnerabilities in or the confusion of autonomous command and control systems must be able to be effectively repelled. This paper builds on the concept of network and computing system intrusion detection system (IDS) technology to present an Interdiction Detection and Prevention System (IDPS) that serves to identify and respond to attacks on autonomous control systems and software. The use of multiple IDS technologies for the detection component of the IDPS is discussed and the efficacy of each is considered. Then preventative and responsive actions are discussed. An architecture and implementation of the IDPS are presented and evaluated. The paper concludes with a discussion of the efficacy of the IDPS for multiple applications and the ‘spy versus spy’ nature of autonomy, anti-autonomy and autonomous system assurance.
High-Frequency Single-Switch ZVS Gate Driver Based on a Class $\Phi _2$ Resonant Inverter

This paper introduces a new type of switched-mode gate driver, which is capable of operating at high frequencies. This topology satisfies requirements of small passive storage components, low-voltage stress, and high design flexibility. Most popular gate-drive circuits require at least two transistors. The proposed circuit has only a single transistor and is suitable for operation at switching frequencies on the order of several megahertz. The output voltage of the gate driver is a quasi-rectangular waveform shaped by a resonant network to produce the desired gate–source voltage waveform. A detailed steady-state operation of the proposed gate driver is discussed. The power-loss analysis and design procedure are presented. Experimental results are given to verify the presented analytical approach. A laboratory prototype of the gate driver is designed, built, and tested at a switching frequency of 20 MHz.
Family-centered critical care: an option or obligation?

The patient was dying after undergoing aggressive treatment for a malignancy. Patient and family wanted "everything" to be done and the patient was transferred to the ICU for treatment of acute respiratory failure. The next day the patient's condition deteriorated further. The family decided against chest compressions or defibrillation; however, other aggressive treatment was continued. A "chemical code" was initiated and the patient was ventilated. The family was informed. As they stood in the hall outside the unit, the patient's wife asked if she could be with her husband. A nurse explained what she would see and accompanied her to the bedside. She stood at the head of the bed, stroked her husband's head and spoke softly in his ear. The patient's son came to the bedside and said his last words to his father. The wife was present when treatment was stopped and the patient was pronounced dead. She said to the nurse who had accompanied her, "You have given me the greatest gift possible--you allowed me to be with my husband at the end."
Endovascular drug-delivery and drug-elution systems

Abstract Stents have changed medicine and the treatment of obstructive vascular disease. Technology advancement and outcomes of numerous clinical trials have led to development of different generations of stents and other novel endovascular implants. Herewith, we briefly discuss the evolution of coronary intervention from balloon angioplasty to contemporary alternatives such as second-generation drug-eluting stents, bioresorbable scaffolds, drug-eluting balloons, and polymer-free stents. We briefly present clinical outcomes, solved/remaining challenges for each category, and accumulating evidence on effectiveness and safety of emerging therapies. With computational modeling playing an ever-increasing role in designing medical devices, we also review the impact of such models on understanding and optimizing drug delivery in stents. Interventional cardiology has made great strides because technological innovation has marched in lock step with advances in understanding the basic science of vascular repair. The continued evolution of endovascular therapies will rely on retaining this link between mechanistic insight and enlightened technical development.
Validity and Responsiveness of Floor Sitting-Rising Test in Post-Total Knee Arthroplasty: A Cohort Study.

Abstract Objectives To assess the construct validity and responsiveness of the floor sitting-rising test (SRT) in individuals with total knee arthroplasty (TKA). Design Cohort study with 6-month follow-up. Secondary analysis using data from a randomized controlled trial. Setting An outpatient rehabilitation research center. Participants Participants (N=240) enrolled in the parent study who had unilateral primary TKA. Intervention Participants in the parent study underwent 12 weeks of exercise programs. Main Outcome Measures Validity analysis correlated baseline data of participants who completed the SRT and measures of knee motion, muscle strength, performance-based tests, and patient-reported outcomes of physical and psychosocial function. Responsiveness analysis used the 3- and 6-month follow-up data. Effect sizes were calculated using changes from baseline. Areas under the receiving operating characteristics curve were calculated using a global rating of change as the external anchor. Results Of the 240 participants (148 women; age, 70±7y), 180 (75%) were able to perform the SRT at baseline. Performers scored significantly better in all physical function tests (P Conclusions The results add evidence to the validity of the SRT in patients after TKA. The strength of the associations suggests that the SRT measures a physical function construct not captured by the other tests. The magnitude of indices of responsiveness for the SRT were similar to other performance-based tests, indicating comparable responsiveness to more widespread tests of functional performance.
Burden is in the eye of the beholder: Sensitivity of yellow fever disease burden estimates to modeling assumptions

ABSTRACT Geographically stratified estimates of disease burden play an important role in setting priorities for the management of different diseases and for targeting interventions against a single disease. Such estimates involve numerous assumptions, which uncertainty about is not always well accounted for. We developed a framework for estimating the burden of yellow fever in Africa and evaluated its sensitivity to assumptions about the interpretation of serological data and choice of regression model. We addressed the latter with an ensemble approach, and we found that the former resulted in a nearly twentyfold difference in burden estimates (range of central estimates: 8.4×104-1.5×106 deaths in 2021-2030). Even so, statistical uncertainty made even greater contributions to variance in burden estimates (87%). Combined with estimates that most infections go unreported (range of 95% credible intervals: 99.65-99.99%), our results suggest that yellow fever’s burden will remain highly uncertain without major improvements in surveillance.
Are There Useful Lessons from the 1990-91 Oil Price Shock?

Following Iraqs invasion of Kuwait, oil prices temporarily doubled. This paper examines the hypothesis that the U.S. economy had changed following previous oil price shocks, so that the 1990 oil price rise (and its subsequent decline) had smaller effects than previously. It also examines a related hypothesis that such a transitory oil price hike would have little or no macroeconomic effect. It surveys and rejects arguments for a reduced impact of oil price shocks and for hysteresis. The article argues that recent experience was comparable in magnitude to earlier shocks and that there were comparable macroeconomic developments and changes in the composition of output. The paper concludes with a test of the effect of energy prices on the misery index and shows that recent changes in misery are consistent with previous experience.
Response to ‘Haptoglobin in diagnosis of sepsis’

We appreciate the interest and the insightful comments that Dr Philip made about our article. We regret the omission of reference to his studies in our manuscript; his work on the subject done several decades ago has made a significant contribution to the knowledge of the kinetics and the role of haptoglobin (Hp) in newborns. Our results are in accordance with his findings and contribute with new information particularly concerning the early preterm group, as 14 patients in our study were born at <32 weeks gestational age. However, other researchers have been unable to detect Hp consistently in newborns, regardless of gestational age.1, 2, 3 The establishment of normal Hp values for premature and term newborns continues to be controversial. We hope that our work will contribute to improve the accuracy of neonatal Hp values provided by many clinical laboratories and various reference texts that generally report them at zero or do not provide them at all.4, 5, 6
Preenrichment versus direct selective agar plating for the detection of Salmonella Enteritidis in shell eggs.

The relative effectiveness of two methods for the recovery of Salmonella Enteritidis (SE) from jumbo and medium shell eggs was compared. The first method used in the comparison consisted of a preenrichment of the sample, and the second method was developed by the U.S. Department of Agriculture's Animal and Plant Health Inspection Service (APHIS). Three bulk lots of blended, pooled eggs, each containing 220 liquid whole eggs that were thoroughly mixed manually were artificially inoculated with different levels of SE cells between approximately 100 and 103 CFU/ml. Twenty samples containing the contents of approximately 10 eggs each (by weight) were withdrawn from each of the inoculated bulk lots and incubated for 4 days at room temperature (ca. 23°C). For the APHIS method, each sample was cultured by direct plating onto brilliant green (BG), brilliant green with novobiocin (BGN), xylose lysine desoxycholate (XLD), and xylose lysine agar Tergitol 4 (XLT4) agars. For the preenrichment method, 25-g portions fr...
B27−: Appearance of the smallest planar boron cluster containing a hexagonal vacancy

Photoelectron spectroscopy and ab initio calculations have been carried out to probe the structures and chemical bonding of the B27− cluster. Comparison between the experimental spectrum and the theoretical results reveals a two-dimensional (2D) global minimum with a triangular lattice containing a tetragonal defect (I) and two low-lying 2D isomers (II and III), each with a hexagonal vacancy. All three 2D isomers have 16 peripheral boron atoms and 11 inner boron atoms. Isomer I is shown to be mainly responsible for the observed photoelectron spectrum with isomers II and III as minor contributors. Chemical bonding analyses of these three isomers show that they all feature 16 localized peripheral B–B σ-bonds. Additionally, isomer I possesses 16 delocalized σ bonds and nine delocalized π bonds, while isomers II and III each contain 17 delocalized σ bonds and eight delocalized π bonds. It is found that the hexagonal vacancy is associated generally with an increase of delocalized σ bonds at the expense of delo...
A critical embracing of the digital lawyer

This essay is a contribution to the Educating the Digital Lawyer book project and addresses methods by which the legal academy might critically embrace the digitalization of legal practice, and a necessarily concurrent set of modifications to standard forms of legal education. The analytical approach of the essay is derived from Science and Technology Studies (STS), and particularly emphasizes the way that interdisciplinary domain draws attention to the porousness of the borders between technoscientific domains and social domains — including that of law — and the various ways in which technical artifacts (i.e., communication and information technologies), in addition to their most ostensible functional qualities, also exhibit regulatory effects; that is, the various ways that technologies function quasi-legislatively.
Theories, Patterns and reality: Game plan for arthropod phylogeny

In a series of papers some years ago (Emerson and Schram, 1990a,b; Schram and Emerson, 1991) we proposed Arthropod Pattern Theory (APT). Before Michael Emerson’s death (22 March, 1990), he and I had planned to perform a cladistic analysis of the fossil and recent arthropods using APT features. He prepared a preliminary data set, and we actually ran some analyses. A series of circumstances, however, intervened after the preparation of Schram and Emerson (1991), and time and opportunity only now have presented themselves to allow one of us (F.R.S.) to take this project up again. This still remains, nevertheless, very much a joint effort, since Michael had prepared before his death extensive notes and observations concerning arthropod body plans, and these have formed the foundation of this analysis.
Design Heuristics: Cognitive Strategies for Creativity in Idea Generation

This paper explores the use of heuristics as cognitive strategies invoked during the process of design. We propose new heuristics for design that provide ways to explore the problem space of potential designs, and often lead to the generation of creative solutions. We test whether Design Heuristics can be taught to novices, and whether doing so will improve the creativity of their resulting designs.
The Role of Obesity Training in Medical School and Residency on Bariatric Surgery Knowledge in Primary Care Physicians

Objective. US primary care physicians are inadequately educated on how to provide obesity treatment. We sought to assess physician training in obesity and to characterize the perceptions, beliefs, knowledge, and treatment patterns of primary care physicians. Methods. We administered a cross-sectional web-based survey from July to October 2014 to adult primary care physicians in practices affiliated with the Massachusetts General Hospital (MGH). We evaluated survey respondent demographics, personal health habits, obesity training, knowledge of bariatric surgery care, perceptions, attitudes, and beliefs regarding the etiology of obesity and treatment strategies. Results. Younger primary care physicians (age 20-39) were more likely to have received some obesity training than those aged 40-49 (OR: 0.08, 95% CI: 0.008-0.822) or those 50+ (OR: 0.03, 95% CI: 0.004-0.321). Physicians who were young, had obesity, or received obesity education in medical school or postgraduate training were more likely to answer bariatric surgery knowledge questions correctly. Conclusions. There is a need for educational programs to improve physician knowledge and competency in treating patients with obesity. Obesity is a complex chronic disease, and it is important for clinicians to be equipped with the knowledge of the multiple treatment modalities that may be considered to help their patients achieve a healthy weight.
Post-traumatic brain hypothermia reduces histopathological damage following concussive brain injury in the rat

The purposes of this study were (1) to document the histopathological consequences of moderate traumatic brain injury (TBI) in anesthetized Sprague-Dawley rats, and (2) to determine whether post-traumatic brain hypothermia (30 degrees C) would protect histopathologically. Twenty-four hours prior to TBI, the fluid percussion interface was positioned over the right cerebral cortex. On the 2nd day, fasted rats were anesthetized with 70% nitrous oxide, 1% halothane, and 30% oxygen. Under controlled physiological conditions and normothermic brain temperature (37.5 degrees C), rats were injured with a fluid percussion pulse ranging from 1.7 to 2.2 atmospheres. In one group, brain temperature was maintained at normothermic levels for 3 h after injury. In a second group, brain temperature was reduced to 30 degrees C at 5 min post-trauma and maintained for 3 h. Three days after TBI, brains were perfusion-fixed for routine histopathological analysis. In the normothermic group, damage at the site of impact was seen in only one of nine rats. In contrast, all normothermic animals displayed necrotic neurons within ipsilateral cortical regions lateral and remote from the impact site. Intracerebral hemorrhagic contusions were present in all rats at the gray-white interface underlying the injured cortical areas. Selective neuronal necrosis was also present within the CA3 and CA4 hippocampal subsectors and thalamus. Post-traumatic brain hypothermia significantly reduced the overall sum of necrotic cortical neurons (519 +/- 122 vs 952 +/- 130, mean +/- SE, P = 0.03, Kruskal-Wallis test) as well as contusion volume (0.50 +/- 0.14 vs 2.14 +/- 0.71 mm3, P = 0.004).(ABSTRACT TRUNCATED AT 250 WORDS)
Experimental validation of simulated fatigue life estimates in laser‐peened aluminum

Purpose – The purpose of this paper is to develop and implement a structural fatigue life estimation framework that includes laser‐peened (LP) residual stresses and then experimentally validates these fatigue life estimations.Design/methodology/approach – A three‐dimensional finite element analysis of an Al 7075‐O three‐point bending coupon being LP was created and used to estimate the fatigue life when loaded. Fatigue tests were conducted to validate these estimations.Findings – The framework developed for fatigue life estimation of LP‐processed coupons yielded estimates with goodness‐of‐fit between the log‐transformed experimental and analytical data of R2=0.97 for the baseline coupons and R2=0.94 for the LP‐processed coupons.Research limitations/implications – Approximated e‐life fatigue parameters were used to calculate the fatigue life resulting from the complex residual stress fields due to the simulated LP process.Originality/value – A fatigue life estimation framework that considers LP residual st...
Prevention of preterm birth based on short cervix: symptomatic women with preterm labor or premature prelabor rupture of membranes.

The diagnosis of preterm labor (PTL) is challenging, especially in women whose cervical dilatation is 15 mm. Transvaginal ultrasound CL can also be performed in the presence of ruptured membranes and predicts latency. Although additional data are needed, the evidence so far suggests that the use of transvaginal ultrasound CL and fetal fibronectin can be used to better identify and manage women with PTL likely to have an imminent preterm delivery, and to avoid interventions in women who would not.