cssi/SciSciGPT-SciSciNet huggingface dataset:
Assessing Minimum Amounts and Form of Roughages in Ruminant Diets: Roughage Value Index System

Summary Ruminants require adequate amounts of coarse-textured feeds to avoid metabolic disorders and, in the case of dairy cows, reduced milk fat production. Coarse-textured feeds help to maintain both proper muscle tone in the digestive system and proper rumen pH, both of which contribute to productivity and health. Texture of feeds is quantitatively reflected in the chewing activity of ruminants, and chewing stimulates saliva secretion. Saliva contains bicarbonates and other buffers that alter tureen environment and help avert disorders. Because chewing time reflects feed texture, a series of experiments were conducted in which feed intake, chewing time and milk and fat produc- tion were measured. Roughage value indexes (RVI) were partitioned for feed ingredients from regression equations. In addition, an equation was developed that predicts RVI from sieving and chemical data: RVI = 10.86 + PS (21.59) - DMI (1.91) + NDF (.541), where RVI is minutes/kilogram, PS is particle size in mean diameter, DMI is dry matter intake in kilograms and NDF is neutral detergent fiber percentage. The minimum RVI for the produc- tion of 3.5% fat milk was determined. By coupling an RVI requirement of 31 min/kg with feed RVI, one can formulate, by computer, diets for lactating cows that not only are nutritionally adequate, but also are adequate in a Presented at the Symposium on "Potential Com- plications Associated with Feeding Ruminants
Chronic CO exposure stimulates erythropoiesis but not glomus cell growth.

The effect of chronic CO exposure, which stimulates erythropoietin production and erythropoiesis, was studied on carotid body cells in the rat. The hypothesis to be tested was that chronic CO inhalation would stimulate cellular hypertrophy and hyperplasia of carotid body if it caused local tissue hypoxia as in chronic hypoxia. The failure of an appropriate response would indicate a lack of a specific local effect on carotid body tissue PO2 presumably because of its unusually high tissue blood flow. Six young male rats were exposed to 0.4–0.5 Torr (0.05–0.07%) inspired PCO in air for 22 days. Control rats (n = 6) were maintained under similar conditions except for CO exposure. After the exposure period the rats were anesthetized, blood was collected for hematocrit, and the carotid bodies were surgically exposed and fixed for electron microscopy and morphometry of type I and type II cells and capillary endothelium. Hematocrit was significantly greater in the CO-exposed group (75 vs. 48%), whereas no significant difference was found in the carotid body parenchyma between the control and CO-exposed groups. We conclude that the lack of an effect of chronic CO exposure on the carotid bodies in contrast to the strong erythropoietic response indicates a relatively high tissue blood flow rate in the carotid body and that CO did not exert a direct cellular effect. The results also suggest that the hypertrophic response of carotid body glomus cells to chronic hypoxic hypoxia is the result of a local direct effect of low PO2 rather than secondary to systemic effects.
The multipliers for functions with fourier transforms in Lp (Ĝ)

In this chapter we shall discuss the Banach algebras A P (G) of elements in L1(G) whose Fourier transforms belong to L p (Ĝ) and the multipliers for these algebras. These algebras are similar to the group algebra L1(G) in a great many ways. In particular for noncompact groups we shall see that the algebras A p (G) and L1(G) have the same multipliers. However the algebras A p (G) are neither group nor QCG algebras. This leads to the observation that the nature of the multipliers of a commutative Banach algebra, by itself, contributes little information as to the character of the algebra. When G is a compact group it will be seen that the bounded measures M(G) form a proper subset of the multipliers for A p (G). In this case we shall also characterize the multipliers of A P (G) as the dual space of a certain Banach space of continuous functions.
Valuation and investment of generation assets

The re-regulation of electric power industry around the world has raised many new challenges for all stakeholders. This research is to valuate generation assets within reregulated electricity markets, both in short-term and long-term. The focus is to valuate operation flexibility under market uncertainties from the viewpoint of a Generation Company (GENCO). This research proposes to model the movements of electricity markets with Hidden Markov Model (HMM) driven by underlying market forces. An electricity market is modeled as a dynamic system evolving over time according to Markov processes. At any time interval, the electricity market can be in one state and transit to another state in the next time interval. The true market states are hidden from a market participant behind the incomplete observation. The observations, such as market-clearing price and quantity, are modeled to follow multiple probabilistic distributions. This research proposes to further decompose the market forces into physical and economic drivers if a specific electricity market employs Location Marginal Price (LMP) mechanism. The physical drivers include transmission network topology and generation technology. The economic drivers include fuel prices, demand uncertainties, and profit maximization of market participants with incomplete information. The decomposition captures the strengths of engineering-based production cost approach and mark-to-market stochastic approach. This research valuates generation assets with real option analysis. The value of generation assets is maximized based on the Hidden Markov Model (HMM) and newest observation of electricity markets. Such an optimization problem is formulated as Partially Oberserable Markov Decision Problem (POMDP). The solution of a POMDP provides a GENCO both the optimal operating policy and values of generation assets. The value of perfect and imperfect information is also identified. Investment in generation assets is also analyzed with real option. This research incorporates fuzzy sets and numbers to capture the fuzziness and possibilities of long-term electricity markets movements. Fuzzy sets and numbers provide the modeler flexibilities to
Molecular Structure Calculations on the Cray-XMP and Cyber 205 Supercomputers at NASA AMES

Selected molecular structure calculations performed on the NASA Ames CRAY-XMP and CYBER 205 supercomputers are described. We first present an overview of the work underway at Ames. We then present a more detailed discussion of the computation of accurate dissociation energies of ionic diatomic and triatomic molecules, and of studies on small metal clusters that serve as a model for both perfect crystal faces and small gas phase particles. These examples illustrate that supercomputers significantly increase the size of the systems that can be considered, as well as the accuracy to which spectroscopic parameters can be determined.
Impact of salesperson macro-adaptive selling strategy on job performance and satisfaction

Abstract Drawing on the tenants of the adaptive strategy paradigm and configuration theory in the management and marketing literature, a model introducing the concept of salesperson macro-adaptive selling strategy that considers the overall selling environment, as contrasted with micro-adaptive selling tactics tailored to a specific customer, is introduced and investigated empirically within the context of the financial services industry. Using a widely accepted management theory typology—prospector, defender, analyzer—the model places macro-adaptive selling strategy into the sales performance literature as an expanded more holistic understanding of strategies influencing salesperson performance. Findings indicate significant direct and indirect effects on sales performance and job-related incomes, including job involvement, effort, and job satisfaction, for salespeople using different macro-adaptive selling strategies.
Hospital at home‐plus: a platform of facility‐based care

SECTIONSPDFPDFTOOLS SHARE Abstract OBJECTIVES To describe the evolution of a hospital at home (HaH) program to a HaH with a 30‐day posthospitalization transition period (HaH‐Plus) and results of a retrospective review of cases. DESIGN After launching HaH‐Plus, we used the same interdisciplinary clinical team to provide acute home‐based care for a broader range of home‐based acute‐level services than originally conceived in the Hospital at Home model. These included a palliative care unit at home (PCUaH), an observation unit at home (OUaH), a post‐acute care rehabilitation at home (RaH), and a program for the hospital averse – those patients needing to be in the hospital but who refuse. SETTING Urban health system. PARTICIPANTS Individuals 18 years or older residing in specified catchment area with Medicare fee‐for‐service or accepted Medicare/Medicaid Advantage plans requiring facility‐based care. INTERVENTION Provision of facility‐based acute‐level care at home to 685 participants. MEASUREMENTS Length of stay, readmission, and mortality. RESULTS HaH‐Plus cared for 685 individuals. The PCUaH had the oldest participants (mean age 87), and all groups were predominantly female and dually eligible for Medicare and Medicaid. Diagnoses and length of stay were similar in all groups except that those in RaH had a larger group of diagnoses, than those accepted in to HaH‐Plus and those in OUaH had a shorter stay. Rate of readmission was highest for RaH (19%). Mortality during the active treatment episode was highest for PCUaH and hospital averse as compared to HaH‐Plus, OUaH and RaH. CONCLUSION Providing a broader range of facility‐based care in the home has significant advantages for patients and increases the scalability of HaH. Developing a spectrum of services was possible by leveraging a robust, 24‐hour HaH team. Community‐ and home‐based care could become a greater part of the U.S. healthcare system if a platform of HaH services along with advances in technology and payment models were developed.
Optimal Signcryption from Any Trapdoor Permutation.

We build several highly-practical and optimized signcryption constructions directly from trapdoor permutations, in the random oracle model. All our constructions share features such as simplicity, efficiency, generality, near-optimal exact security, flexible and ad-hoc key management, key reuse for sending/receiving data, optimally-low message expansion, “backward” use for plain signature/encryption, long message and associated data support, the strongest-known qualitative security (so-called IND-CCA and sUF-CMA) and, finally, complete compatibility with the PKCS#1 infrastructure. While some of these features are present in previous works to various extents, we believe that our schemes improve on earlier proposals in at least several dimensions, making the overall difference quite noticeable in practice. Concretely, we present three methods generally based on what we call Parallel, Sequential, and eXtended sequential Padding schemes (P-Pad, S-Pad, X-Pad). P-Pad offers parallel “signing” and “encrypting”, optimal exact security, and minimum ciphertext length twice as long as the length of a TDP, while still maintaining optimal bandwidth. S-Pad loses parallelism and some exact security, but has minimal ciphertext length equal to that of a TDP. Any S-Pad can also be used as a “universal padding” scheme. X-Pad is similar to S-Pad, but regains optimal exact security at the expense of a marginally-longer minimum ciphertext length. Moreover, to unify various padding options, we construct a single versatile padding scheme PSEP which, by simply adjusting the lengths of the parameters, can work optimally as either a P-Pad, S-Pad or X-Pad.
Genomic-Based Therapy of Gynecologic Malignancies.

This paper will review the current status of genomic-based therapy of gynecologic malignancies. The routine “standard-of-care” delivery of targeted therapeutics based on the presence of specific molecular biomarkers in the management of the gynecologic malignancies has been delayed compared to the substantial progress made in several other tumor types. However, relatively recently reported and rather robust phase 3 trial data have confirmed a potentially major role for PARP inhibitors as both active treatment and maintenance therapy of advanced ovarian cancer. Further, data demonstrating the presence of a specific molecular phenotype (micro-satellite instability high – MSI-H) is a valid biomarker for the potential clinical utility of checkpoint inhibitor immunotherapy has relevance for all gynecologic malignancies, and particularly in the setting of metastatic or recurrent endometrial cancer. Conclusions. The introduction of PARP inhibitors into the oncology armamentarium has substantially impacted standard-of-care strategies in the management of ovarian cancer. It is anticipated that the results of ongoing and future trials will further define the role of genomic-based therapy in ovarian cancer and other gynecologic malignancies.
Turmeric supplement induced hepatotoxicity: a rare complication of a poorly regulated substance.

Dear Editor,Turmeric has a long history of medicinal use and is thought to have therapeutic properties including liver protective effects and anti-oxidant properties. More recently, there has been ...
The Effects of Amplification on Listening Self-Efficacy in Adults With Sensorineural Hearing Loss

Objectives The aim of this study was to evaluate listening self-efficacy ratings between aided and unaided conditions in different communication environments and to determine what patient- and device-centered variables were associated with individual differences. Method An observational, cross-sectional study design was used to evaluate 165 older adults with mild to moderately severe sensorineural hearing loss who wore hearing aids at least 8 hr per week. Listening self-efficacy for both unaided and aided listening was measured using the Listening Self-Efficacy Questionnaire (LSEQ; Smith, Pichora-Fuller, Watts, & La More, 2011), consisting of a global score and subscales of Dialogue in Quiet, Directed Listening, and Complex Listening. Metrics to explain variability in the degree of improvement in LSEQ ratings with aided listening included patient-centered variables of age, pure-tone average, and personality and device-centered variables of hearing aid use, speech intelligibility index, directionality, and noise reduction. The NEO Five-Factor Inventory (Costa & McCrae, 1985) was used to measure 5 personality traits (neuroticism, extraversion, openness, agreeableness, and conscientiousness). Associations were evaluated between LSEQ ratings and patient- and device-centered variables using a linear mixed-model analysis. Results Statistically significant improvements in LSEQ ratings were found for aided conditions (relative to unaided conditions), easier listening environments, lower pure-tone averages, and lower levels of neuroticism. Furthermore, the improvement in listening self-efficacy with hearing aids did not depend on the listening environment but did alter with severity of hearing loss, length of hearing aid use, and levels of conscientiousness. Conclusions Results of this study suggest that wearing hearing aids is associated with improved listening self-efficacy in a variety of communication environments. Aural rehabilitation and counseling may focus on improving listening self-efficacy to address the challenges of consistent hearing aid use and reduced quality of life related to hearing loss.
Charting a New Frontier: The Role of Maps and Geography in Strategic Management and Innovation

External knowledge is often conceived of as a map to guide organizational search. Despite the use of this ""mapping"" metaphor, scholars in strategy and innovation have rarely studied the practical...
Powder-in-Tube Reactive Molten-Core Fabrication of Glass-Clad BaO-TiO2-SiO2 Glass─Ceramic Fibers

In this paper we report the fabrication of glass-clad BaO-TiO2-SiO2 (BTS) glass-ceramic fibers by powder-in-tube reactive molten-core drawing and successive isothermal heat treatment. Upon drawing, the inserted raw powder materials in the fused silica tubing melt and react with the fused silica tubing (housing tubing) via dissolution and diffusion interactions. During the drawing process, the fused silica tubing not only serves as a reactive crucible, but also as a fiber cladding layer. The formation of the BTS glass-ceramic structure in the core was verified by micro-Raman spectroscopy after the successive isothermal heat treatment. Second-harmonic generation and blue-white photoluminescence were observed in the fiber using 1064 nm and 266 nm picosecond laser irradiation, respectively. Therefore, the BTS glass-ceramic fiber is a promising candidate for all fiber based second-order nonlinear and photoluminescence applications. Moreover, the powder-in-tube reactive molten core method offers a more efficient and intrinsic contamination-free approach to fabricate glass-ceramic fibers.
Designing Novel Therapies to Mend Broken Hearts: ATF6 and Cardiac Proteostasis

The heart exhibits incredible plasticity in response to both environmental and genetic alterations that affect workload. Over the course of development, or in response to physiological or pathological stimuli, the heart responds to fluctuations in workload by hypertrophic growth primarily by individual cardiac myocytes growing in size. Cardiac hypertrophy is associated with an increase in protein synthesis, which must coordinate with protein folding and degradation to allow for homeostatic growth without affecting the functional integrity of cardiac myocytes (i.e., proteostasis). This increase in the protein folding demand in the growing cardiac myocyte activates the transcription factor, ATF6 (activating transcription factor 6α, an inducer of genes that restore proteostasis. Previously, ATF6 has been shown to induce ER-targeted proteins functioning primarily to enhance ER protein folding and degradation. More recent studies, however, have illuminated adaptive roles for ATF6 functioning outside of the ER by inducing non-canonical targets in a stimulus-specific manner. This unique ability of ATF6 to act as an initial adaptive responder has bolstered an enthusiasm for identifying small molecule activators of ATF6 and similar proteostasis-based therapeutics.
PREVALENCE OF ASYMPTOMATIC MYOCARDIAL ISCHEMIA IN EXERCISE STRESS ECHOCARDIOGRAPHY

Recent studies continue to highlight the significance and prognosis of silent myocardial infarctions, but few studies identify the burden and significance of myocardial ischemia without symptoms. Patients with positive electrocardiography (ECG) and/or positive echocardiography stress test were
Behavior-based Risk Detection of Autism Spectrum Disorder Through Child-Robot Interaction

This work presents a method to identify children at risk for Autism Spectrum Disorder using behavioral data extracted from video analysis of child-robot interactions. Robots were used as a tool to elicit social engagement from the children in order to capture their social behaviors. A Convolutional Neural Network was used to classify the behavioral data as either at-risk ASD or Typical Development. The network performance was compared to two machine learning classifiers and the utility of the proposed method as a way to streamline existing diagnostic procedures was discussed.
Xanthomonas diversity, virulence and plant–pathogen interactions

Xanthomonas spp. encompass a wide range of plant pathogens that use numerous virulence factors for pathogenicity and fitness in plant hosts. In this Review, we examine recent insights into host-pathogen co-evolution, diversity in Xanthomonas populations and host specificity of Xanthomonas spp. that have substantially improved our fundamental understanding of pathogen biology. We emphasize the virulence factors in xanthomonads, such as type III secreted effectors including transcription activator-like effectors, type II secretion systems, diversity resulting in host specificity, evolution of emerging strains, activation of susceptibility genes and strategies of host evasion. We summarize the genomic diversity in several Xanthomonas spp. and implications for disease outbreaks, management strategies and breeding for disease resistance.
Modeling family leisure and related family constructs: a national study of U.S. parent and youth perspectives.

The purpose of this study was to begin the development of a broad model that could examine the structural relationships between family leisure involvement, family functioning, family communication,...
Iron Overload, Oxidative Stress and Calcium Mishandling in Cardiomyocytes: Role of the Mitochondrial Permeability Transition Pore

Iron (Fe) plays an essential role in many physiological processes. Hereditary hemochromatosis or frequent blood transfusions often cause iron overload (IO), which can lead to cardiomyopathy and arrhythmias; however, the underlying mechanism is not well defined. In the present study, we assess the hypothesis that IO promotes arrhythmias via reactive oxygen species (ROS) production, mitochondrial membrane potential (∆Ψm) depolarization, and disruption of cytosolic Ca dynamics. In ventricular myocytes isolated from wild type (WT) mice, both cytosolic and mitochondrial Fe levels were elevated following perfusion with the Fe3+/8-hydroxyquinoline (8-HQ) complex. IO promoted mitochondrial superoxide generation (measured using MitoSOX Red) and induced the depolarization of the ΔΨm (measured using tetramethylrhodamine methyl ester, TMRM) in a dose-dependent manner. IO significantly increased the rate of Ca wave (CaW) formation measured in isolated ventricular myocytes using Fluo-4. Furthermore, in ex-vivo Langendorff-perfused hearts, IO increased arrhythmia scores as evaluated by ECG recordings under programmed S1-S2 stimulation protocols. We also carried out similar experiments in cyclophilin D knockout (CypD KO) mice in which the mitochondrial permeability transition pore (mPTP) opening is impaired. While comparable cytosolic and mitochondrial Fe load, mitochondrial ROS production, and depolarization of the ∆Ψm were observed in ventricular myocytes isolated from both WT and CypD KO mice, the rate of CaW formation in isolated cells and the arrhythmia scores in ex-vivo hearts were significantly lower in CypD KO mice compared to those observed in WT mice under conditions of IO. The mPTP inhibitor cyclosporine A (CsA, 1 µM) also exhibited a protective effect. In conclusion, our results suggest that IO induces mitochondrial ROS generation and ∆Ψm depolarization, thus opening the mPTP, thereby promoting CaWs and cardiac arrhythmias. Conversely, the inhibition of mPTP ameliorates the proarrhythmic effects of IO.
A Mini Review: The History of Yeast Flocculation with an Emphasis on Measurement Techniques

Flocculation of yeast is a natural phenomenon wherein cells clump together and come out of suspension. This is often relied upon by brewers as a natural means of removing yeast, as clumps of yeast ...
From Social Responsibility to Social Impact: A Framework and Research Agenda

While corporate social responsibility (CSR) has received increasing attention in the management literature, the focus of most prior work has been on the financial implications of CSR activities for firms, rather than on their consequences for social welfare. We contend that this relative neglect stems from the lack of a conceptual framework to evaluate social impact, and offer such a framework in this study. Specifically, we identify four criteria that an activity must meet in order to have an unambiguously positive effect on social welfare: it must be substantive, meaning that it delivers meaningful benefits to those it claims to serve; it must be unequivocal, meaning that these benefits must not be offset by harmful actions by the firm elsewhere; it must be inclusive, meaning that those that do not benefit from the firm’s actions are not left worse off; and it must be comparatively efficient, meaning that the same activity could not be carried out more effectively or efficiently under a different organizational form. By developing a coherent and rigorous framework to assess social impact systematically, our study offers both a research agenda for future scholars, and a useful tool for managers seeking to design more effective CSR initiatives.
A qualitative investigation to identify factors influencing relationship formation between pediatric nurses and pediatric interns

Abstract Background Collaborative relationships between nurses and physicians are fundamental to providing optimal patient care. However, effective communication, building trust and respect, and understanding each other can all be challenges in developing these relationships. Purpose We explore nurse and intern (first year resident) experiences of working together on two general care pediatric floors to more fully understand perceptions of their relationship and identify factors that influence or impede collaborative relationships. Methods Using a semi-structured interview guide, we conducted 3 focus groups; one of nurses (n = 5) and two of second year residents (total n = 6) on two general care pediatric teaching floors at a large academic medical center. Thematic data analysis following the “five stages to qualitative research framework” with three independent coders resulted in six themes. Results Six themes emerged as key factors in the formation of positive relationships between nurses and interns. They included “Roles,” “Trust,” “Communication,” “Respect,” “Relationships,” and “Time.” Both nurses and second year residents reflecting on the intern year identified factors integral to their relationship development. Nurses desire to be valued members of the healthcare team and interns desire to be respected as physicians in training. Both value the importance of effective, in-person communication, desire to be viewed as capable in their roles, appreciate that trust and respect are essential for optimal patient care, and understand that time is needed for these to occur. Conclusions Four shared key factors that lead to positive relationships between nurses and interns must be met for effective collaboration to occur. These include good communication, mutual respect, building trust, and role formation. The establishment of shared factors takes time and may have to be built and rebuilt when they are breeched; determining how to decrease the time for them to be established may enable relationship formation to occur earlier in the intern year.
Psychotropic Medication Prescribing in Primary Care: Pediatric Chief Resident Perspectives.

Abstract Objective Evidence-based treatments for mental health concerns include psychopharmacological and psychosocial approaches. Pediatrics organizations indicate psychopharmacology needs to be a component of training. This study investigated the status of training in psychotropic medication prescribing through a national survey of pediatric chief residents. Method Pediatric chief residents (one per residency program) completed a survey (response rate = 60.2%, 127/211) about their attitudes, knowledge, comfort, practice, and training around prescribing psychotropic medication in primary care. Quantitative data included descriptive statistics and correlational analyses to explore relationships between variables; qualitative data were examined through classical content analysis. Results Almost half of respondents reported prescribing sometimes or often. Frequency of prescribing varied by mental health condition, with highest frequency for attention-deficit/hyperactivity disorder. About two-thirds of respondents reported having at least some/average knowledge. About half of respondents reported being uncomfortable with prescribing; respondents were most uncomfortable with prescribing antianxiety, mood stabilizing, and antipsychotic medications, and with discontinuing medication; about half indicated their competence in progress-monitoring needed improvement. Concurrent psychosocial treatment was perceived as very useful, although often inaccessible to patients. Prescribing frequency was related to knowledge, comfort, progress-monitoring competence, and training quality; training quality was related to knowledge and comfort. Over 60% rated their training as not at all or only somewhat adequate. Conclusions Pediatric chief residents reported having knowledge of psychotropic medication issues, but experience a general discomfort, especially with discontinuing medication, and with medications other than stimulants. Most thought their training needed improvement in terms of comprehensiveness and clinical practice experiences.
Outcomes of end-stage renal disease patients in the PROCESS trial.

Objective Intravenous fluid administration is a main component of sepsis therapy, but physicians are cautious about giving fluids to end-stage renal disease (ESRD) patients out of concern for causing volume overload. We compared the outcomes of septic shock patients with and without ESRD and evaluated the association between early intravenous fluid administration and outcomes. Methods We analyzed patients enrolled in the Protocolized Care for Early Septic Shock (PROCESS) trial, which studied different resuscitation strategies for early septic shock. Stratifying for ESRD, we compared patient characteristics, course of care, and outcomes between ESRD and non-ESRD. Using multivariable logistic regression, we determined the association between 6-hour total fluid volume (> = 30 mL/kg vs Results There were 84 ESRD and 1257 non-ESRD patients. ESRD patients had a higher median Charlson Comorbidity score (5 vs 2, P = 30 mL/kg (66.6% vs 86.7% P = 30 mL/kg intravenous fluid did not alter any outcome. For non-ESRD patients, receiving ≥30 mL/kg of intravenous fluid was associated with increased 90-day mortality (adjusted odds ratio = 1.64; 95% confidence interval, 1.03-2.61). Conclusions In the PROCESS trial, ESRD patients had similar outcomes to non-ESRD patients. Although ESRD patients received less intravenous fluid administration, most received over 30 mL/kg in the first 6 hours. In contrast to non-ESRD patients, receiving ≥30 mL/kg of intravenous fluid was not associated with worse outcomes in ESRD.
Efficacy and safety of intravascular lithotripsy in calcified coronary lesions: A systematic review and meta-analysis.

Abstract Background Intravascular lithotripsy (IVL) is a recently introduced therapeutic modality in the management of calcified coronary lesions (CCAD). IVL delivers sonic pressure waves to modulate calcium, hence promote vessel compliance and optimize stent deployment. Methods We performed a comprehensive literature search for studies that evaluated the utility of adjunctive IVL. The primary outcomes of our study were the clinical success, defined as the ability of IVL to produce residual diameter stenosis Results A total of eight single-arm observational studies, including 980 patients (1011 lesions), were included. 48.8% of the patients presented with acute coronary syndrome. Severe calcifications were present in 97% of lesions. Clinical success was achieved in 95.4% of patients (95%CI:92.9%–97.9%). Angiographic success was achieved in 97% of patients (95%CI:95%–99%). There was an overall increase in postprocedural lumen area as well as significant reduction of calcium angle and maximum calcium thickness. Conclusions IVL seems to have excellent efficacy and safety in the management of CCAD. However, adequately powered RCTs are needed to evaluate IVL compared to other calcium/plaque modifying techniques.
Intravenous Ketamine for Cancer Pain Management, Including Flares During the COVID-19 Pandemic: A Retrospective Study.

OBJECTIVES: Cancer-related neuropathic pain (CNP) affects an increasing proportion of cancer patients, given improved survival, but it remains difficult to treat. There are no studies on an extended intravenous ketamine protocol and its synergies with common neuropathy treatments to treat CNP. This study aims to 1) evaluate the safety and effectiveness of an intravenous ketamine protocol to treat refractory CNP and 2) uncover synergies between ketamine and common neuropathy treatments. METHODS: This is a single-center, retrospective review of 57 patients and 192 infusions, with prospective follow-up on 14 enrolled patients during the coronavirus disease 2019 (COVID-19) pandemic. RESULTS: The etiologies of CNP were as follows: 13 from tumor compression, 25 with chemotherapy-induced peripheral neuropathy, 13 from surgery, and 6 from radiation therapy. Overall, 42 of 57 patients (73.7%) were responders, and 71.8% of responders received >3 weeks of pain relief on their last infusion. Analysis of adjuvant treatments revealed that the combination of serotonin-norepinephrine reuptake inhibitors and ketamine resulted in an increase in responders compared with nonresponders (P < 0.01). Adverse events occurred in 32 of 192 infusions (16.7%). All side effects self-resolved or resolved with intervention per the adverse events protocol. During the pandemic, all 14 currently enrolled patients did not receive ketamine infusions. Thirteen of the 14 patients returned to baseline pain, with 61.5% increasing medications. All experienced worsened function, mobility, mood, or anorexia. CONCLUSION: Intravenous ketamine may be a safe and effective adjuvant treatment for CNP, especially with serotonin-norepinephrine reuptake inhibitors. Larger, prospective studies are warranted and should explore parameters to help prognosticate response to ketamine infusions.
The effects of divided attention at encoding and at retrieval on multidimensional source memory.

Dividing attention (DA) between a memory task and a secondary task results in deficits in memory performance across a wide array of memory tasks, but these effects are larger when DA occurs at encoding than at retrieval. Although some research suggests the effects of DA are equal for item and associative memory, thereby suggesting that DA disrupts all components of an episode to the same extent, there have been relatively few studies directly examining the effects of DA on multiple features of the same episode. In addition, no studies have examined how DA may affect the stochastic dependency between multiple source dimensions of a given episode, which is central to theories of source memory, and episodic memory in general. Thus, in two experiments, we used a multidimensional source memory task-examining memory for items and multiple source features-and separately investigated how DA at encoding or at retrieval affects item memory, source memory, and joint source retrieval. DA was manipulated at encoding in Experiment 1 and at retrieval in Experiment 2. Whereas DA at encoding disrupted item memory, as well as source memory and source-source binding, though to a lesser extent, DA at retrieval did not affect any of these outcomes. Results are discussed in terms of levels of binding and the role of attention in encoding and retrieval of bounded episodic representations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Body Mass Index and In-Hospital Management and Outcomes of Acute Myocardial Infarction.

Background and Objectives: Contemporary data on the prevalence, management and outcomes of acute myocardial infarction (AMI) in relation to body mass index (BMI) are limited. Materials and Methods: Using the National Inpatient Sample from 2008 through 2017, we identified adult AMI hospitalizations and categorized them into underweight (BMI 24.9 kg/m2) groups. We evaluated in-hospital mortality, utilization of cardiac procedures and resource utilization among these groups. Results: Among 6,089,979 admissions for AMI, 38,070 (0.6%) were underweight, 5,094,721 (83.7%) had normal BMI, and 957,188 (15.7%) were overweight or obese. Over the study period, an increase in the prevalence of AMI was observed in underweight and overweight/obese admissions. Underweight AMI admissions were, on average, older, with higher comorbidity, whereas overweight/obese admissions were younger and had lower comorbidity. In comparison to the normal BMI and overweight/obese categories, significantly lower use of coronary angiography (62.3% vs. 74.6% vs. 37.9%) and PCI (40.8% vs. 47.7% vs. 19.6%) was observed in underweight admissions (all p < 0.001). The underweight category was associated with significantly higher in-hospital mortality (10.0% vs. 5.5%; OR 1.23 (95% CI 1.18-1.27), p < 0.001), whereas being overweight/obese was associated with significantly lower in-hospital mortality compared to normal BMI admissions (3.1% vs. 5.5%; OR 0.73 (95% CI 0.72-0.74), p < 0.001). Underweight AMI admissions had longer lengths of in-hospital stay with frequent discharges to skilled nursing facilities, while overweight/obese admissions had higher hospitalization costs. Conclusions: In-hospital management and outcomes of AMI vary by BMI. Underweight status was associated with worse outcomes, whereas the obesity paradox was apparent, with better outcomes for overweight/obese admissions.
Leveraging technology to address unhealthy drug use in primary care: Effectiveness of the Substance use Screening and Intervention Tool (SUSIT).

BACKGROUND Screening for unhealthy drug use is now recommended for adult primary care patients, but primary care providers (PCPs) generally lack the time and knowledge required to screen and deliver an intervention during the medical visit. To address these barriers, we developed a tablet computer-based 'Substance Use Screening and Intervention Tool (SUSIT)'. Using the SUSIT, patients self-administer screening questionnaires prior to the medical visit, and results are presented to the PCP at the point of care, paired with clinical decision support (CDS) that guides them in providing a brief intervention (BI) for unhealthy drug use. Methods: PCPs and their patients with moderate-risk drug use were recruited from primary care and HIV clinics. A pre-post design compared a control 'screening only' (SO) period to an intervention 'SUSIT' period. Unique patients were enrolled in each period. In both conditions, patients completed screening and identified their drug of most concern (DOMC) before the visit, and completed a questionnaire about BI delivery by the PCP after the visit. In the SUSIT condition only, PCPs received the tablet with the patient's screening results and CDS. Multilevel models with random intercepts and patients nested within PCPs examined the effect of the SUSIT intervention on PCP delivery of BI. Results: 20 PCPs and 79 patients (42 SO, 37 SUSIT) participated. Most patients had moderate-risk marijuana use (92.4%), and selected marijuana as the DOMC (68.4%). Moderate-risk use of drugs other than marijuana included cocaine (15.2%), hallucinogens (12.7%), and sedatives (12.7%). Compared to the SO condition, patients in SUSIT had higher odds of receiving any BI for drug use, with an adjusted odds ratio of 11.59 (95% confidence interval: 3.39, 39.25), and received more elements of BI for drug use. Conclusions: The SUSIT significantly increased delivery of BI for drug use by PCPs during routine primary care encounters.
Overdiagnosis and the Information Problem

There are several factors which increase our propensity to overdiagnose, whereas the root cause of overdiagnosis is imperfect information and the trade-offs as a result of that imperfection.
Ballistic Trauma in Children

The natural inquisitiveness and vulnerability of early life predispose children to penetrating injury; varying in severity from a minor laceration or foreign body penetration to life-threatening impalement, stab wound, or missile injury. Ballistic injuries, defined as injuries caused by thrown or projected missiles, comprise an important proportion of pediatric penetrating injury. Penetrating injuries are responsible for approximately 15% of pediatric trauma deaths in developed countries.1 Injury patterns differ widely between different communities, socioeconomic groups, cities, countries, and cultures. Such injuries are also more common during times of revolution or sociopolitical change.
Holding the World Bank Accountable for Leakage of Funds from Africa's Health Sector

This article explores the accountability of international financial institutions (IFIs), such as the World Bank, for human rights violations related to the massive leakage of funds from sub-Saharan Africa's health sector.Beginning by summarizing the quantitative results of Public Expenditure Tracking Surveys performed in six African countries, all showing disturbingly high levels of leakage in the health sector, this article then addresses the inadequacy of good governance and anti-corruption programs in remedying this problem; explains how the World Bank's Inspection Panel may serve as an accountability mechanism for addressing the leakage of funds; discusses violations of specific Bank policies and procedures that would support a claim related to leakage and examining the relevance of human rights concerns to such as claim; and explores some of the Panel's limitations and the positive steps taken to address these concerns.
Establishing a Statistical Link between Network Oscillations and Neural Synchrony

Pairs of active neurons frequently fire action potentials or “spikes” nearly synchronously (i.e., within 5 ms of each other). This spike synchrony may occur by chance, based solely on the neurons’ fluctuating firing patterns, or it may occur too frequently to be explicable by chance alone. When spike synchrony above chances levels is present, it may subserve computation for a specific cognitive process, or it could be an irrelevant byproduct of such computation. Either way, spike synchrony is a feature of neural data that should be explained. A point process regression framework has been developed previously for this purpose, using generalized linear models (GLMs). In this framework, the observed number of synchronous spikes is compared to the number predicted by chance under varying assumptions about the factors that affect each of the individual neuron’s firing-rate functions. An important possible source of spike synchrony is network-wide oscillations, which may provide an essential mechanism of network information flow. To establish the statistical link between spike synchrony and network-wide oscillations, we have integrated oscillatory field potentials into our point process regression framework. We first extended a previously-published model of spike-field association and showed that we could recover phase relationships between oscillatory field potentials and firing rates. We then used this new framework to demonstrate the statistical relationship between oscillatory field potentials and spike synchrony in: 1) simulated neurons, 2) in vitro recordings of hippocampal CA1 pyramidal cells, and 3) in vivo recordings of neocortical V4 neurons. Our results provide a rigorous method for establishing a statistical link between network oscillations and neural synchrony.
De novo malignancy in pediatric organ transplant recipients

Abstract Study of 7,393 types of cancer that occurred in 6,934 organ transplant recipients showed that the pattern of malignancies that developed in pediatric recipients was very different from that of the general pediatric population and that of adult recipients. Tumors (334) occurred in 326 pediatric patients (aged ≤ 18 years), and 7,059 neoplasms occurred in 6,608 adults. Lymphomas were the predominant cancer in pediatric recipients and comprised 50% of all tumors compared with 15% in adult recipients. Among lymphomas in pediatric patients, 85% occurred during childhood. Of the patients who had lymphoma, there was a preponderance of recipients of nonrenal organs (61%); of those who had nonlymphomatous tumors, only 13% received nonrenal organs. The second most common malignancy in pediatric patients was skin cancer (20% of tumors), but this occurred less frequently than in adult recipients, for whom it comprised 38% of neoplasms. In only 11 pediatric patients (16%) did skin cancers develop during childhood (5 had malignant melanomas), with an average time of appearance after transplantation of 118 months (range, 9.5 to 282 months). Malignant melanomas were more common in pediatric than adult recipients (15% v 5% of skin cancers), as were lip cancers (29% v 13%). Spread to lymph nodes was also more common in pediatric than in adult recipients (13% v 6%). The third most common tumor (4%) in patients who had transplantation during childhood was carcinoma of the vulva, perineum, and/or anus. These patients were female, and the tumors occurred after childhood, at an average of 140 months (range, 43–262 months) posttransplantation. Sarcomas comprised 3% of all malignancies and 1% of those in adults. Ten pediatric patients (3%) had liver neoplasms (9 hepatomas, 1 hepatoblastoma). Other cancers observed in pediatric recipients were thyroid carcinomas (9), Kaposi's sarcoma (8), head and neck tumors (7), carcinomas of the cervix (6), leukemias (6), ovarian carcinomas (5), brain tumors (5), renal carcinomas (5), and miscellaneous tumors (14). Of all 334 malignancies, 192 (57%) appeared during childhood and 142 (43%) occurred between the ages of 19 and 39 years. By far the most common tumor diagnosed during childhood was lymphoma, which comprised 142 (74%) of the 192 malignancies.
The hippocampus as an associator of discontiguous events

The hippocampus has long been thought to be an important cortical region for associative learning and memory. After several decades of experimental and theoretical studies, a picture is emerging slowly of the generic types of learning tasks that this neural structure might be essential for solving. Recently, there have been attempts to unify electrophysiological and behavioral observations from rodents performing spatial learning tasks with data from primates performing various tests of conditional and discrimination learning. Most of these theoretical frameworks have rested primarily on behavioral observations. Complementing these perspectives,we ask the question: given certain physiological constraints at the neuronal and cortical level, what class of learning problems is the hippocampus, in particular, most suited to solve? From a computational point of view, we argue that this structure is involved most critically in learning and memory tasks in which discontiguous items must be associated, in terms of their temporal or spatial positioning, or both.
Semiautomated segmentation and 3D reconstruction of coronary trees: biplane angiography and intravascular ultrasound data fusion

In this paper, we describe an approach to 3D reconstruction of the coronary tree based on combined use of biplane coronary angiography and intravascular ultrasound (IVUS). Shortly before the start of a constant-speed IVUS pullback, radiopaque dye is injected into the examined coronary tree and the heart is imaged with a calibrated biplane X-ray system. The 3D centerline of the coronary tree is reconstructed from the geometrically corrected biplane angiograms using an automated segmentation method and manual matching of corresponding branching points. The borders of vessel wall and plaque are automatically detected in the acquired pullback images and the IVUS cross sections are mapped perpendicular to the previously reconstructed 3D vessel centerline. In addition, the twist of the IVUS probe due to the curvature of the coronary artery is calculated for a torsion-free catheter and the whole vessel reconstruction is rotationally adjusted using available anatomic landmarks. The accuracy of the biplane reconstruction procedure is validated by means of a left coronary tree phantom. The feasibility of the entire approach is demonstrated in a cadaveric pig heart.