cssi/SciSciGPT-SciSciNet huggingface dataset:
Prioritized resource assignment for mobile cellular communication systems with mixed services and platform types

The proliferation of mobile, portable, and personal communication systems will bring a variety of offered services. Practical systems that are envisioned must support different types of calls. These may include voice only, mixed voice and data, high-speed data, low-speed data, image transmission, and an array of intelligent network services. In addition there may be a mixture of platforms (such as persons, autos, buses, trains, boats, and planes) having a range of mobility characteristics. In such environments, the bandwidth and/or resources needed for different call sessions will not be identical. As a result, calls will generally encounter different blocking and hand-off constraints. These effects are in addition to differences in blocking and forced (call) termination probabilities that are attributable to differing platform mobilities and (resource) channel quotas. Cellular systems with mixed platforms that support calls with differing resource requirements are considered. Loss-type systems and hybrid delay-loss systems are treated. In each case, priority access to resources for hand-off calls is allowable. We identify a suitable state characterization and framework for a performance analysis that enables numerical computation of theoretical performance results. Example performance characteristics are obtained. These show carried traffic, blocking probability, and forced termination probability for each platform type and for each call type.
Human Globin Knock-in Mice Complete Fetal-to-Adult Hemoglobin Switching in Postnatal Development

Elevated levels of fetal -globin can cure disorders caused by mutations in the adult -globin gene. This clinical finding has motivated studies to improve our understanding of hemoglobin switching. Unlike humans, mice do not express a distinct fetal globin. Transgenic mice that contain the human -globin locus complete their fetal-to-adult hemoglobin switch prior to birth, with human -globin predominantly restricted to primitive erythroid cells. We established humanized (100% human hemoglobin) knock-in mice that demonstrate a distinct fetal hemoglobin (HbF) stage, where -globin is the dominant globin chain produced during mid- to late gestation. Human - and -globin gene competition is evident around the time of birth, and -globin chain production diminishes in postnatal life, with transient production of HbF reticulocytes. Following completion of the - to--globin switch, adult erythroid cells synthesize low levels of HbF. We conclude that the knock-in globin genes are expressed in a pattern strikingly similar to that in human development, most notably with postnatal resolution of the fetal-to-adult hemoglobin switch. Our findings are consistent with the importance of BCL11A in hemoglobin switching, since removal of intergenic binding sites for BCL11A results in human -globin expression in mouse definitive erythroid cells. Mammalian globin gene family members are temporally regulated to produce different hemoglobins during embryonic, fetal, and adult life. Humans are born with high levels of fetal hemoglobin (HbF) in their red blood cells (RBCs) and complete the switch to adult hemoglobin (HbA) during the first year of life (32, 43). Patients with mutations in their adult -globin genes that cause thalassemia or hemoglobinopathies like sickle cell anemia are clinically normal at birth but become progressively anemic upon completion of their fetal-to-adult hemoglobin switch. Understanding this hemoglobin switch is of great clinical importance, because disease in these patients could be averted by reactivating the fetal globin gene or by preventing the switch to the adult gene altogether. Generation of an in vivo animal model that recapitulates the postnatal human fetal-to-adult hemoglobin switch would be a valuable research tool for examining the mechanism of hemoglobin switching. Hemoglobin is a tetrameric protein composed of two -like and two -like globin chains. The genes encoding these - and -like chains are grouped into separate loci that are regulated by distant enhancers, such as the locus control region (LCR), located upstream of the -like globin structural genes (16, 18, 19, 26). The human -globin locus (Fig. 1A) is comprised of five functional genes (e, G , A , , and ) organized 5 to 3 in
Intanza®: a new intradermal vaccine for seasonal influenza

Seasonal influenza causes annual epidemics in temperate climates and is associated with economic costs, morbidity and mortality. Vaccination is the primary method of prevention. Intanza(®) (Sanofi Pasteur, Lyon, France) is a newly licensed, trivalent, inactivated influenza vaccine that is delivered intradermally with a proprietary micoinjection system. Two dosage formulations have been approved for use in Europe and Australia. The dosage level of 9 µg of hemagglutinin per strain is approved for persons 18-59 years of age, and its immunogenicity is noninferior to the standard dosage (15 µg per strain) administered intramuscularly. In addition, the dosage level of 15 µg of hemagglutinin per strain administered intradermally is approved for persons 60 years of age and older and has superior immunogenicity compared with that induced by the same dosage administered intramuscularly. Intanza has more frequent injection-site reactions than intramuscularly delivered vaccine, but it is safe and well tolerated. Intanza provides a new option for the prevention of influenza.
Strategies for modulating the inflammatory response after decompression from abdominal compartment syndrome

Management of the open abdomen is an increasingly common part of surgical practice. The purpose of this review is to examine the scientific background for the use of temporary abdominal closure (TAC) in the open abdomen as a way to modulate the local and systemic inflammatory response, with an emphasis on decompression after abdominal compartment syndrome (ACS). A review of the relevant English language literature was conducted. Priority was placed on articles published within the last 5 years. Recent data from our group and others have begun to lay the foundation for the concept of TAC as a method to modulate the local and/or systemic inflammatory response in patients with an open abdomen resulting from ACS.
The diagnostic value of parathyroid hormone washout after fine-needle aspiration of suspicious cervical lesions in patients with hyperparathyroidism.

Objectives/Hypothesis We aimed to study the diagnostic value of parathyroid hormone (PTH) concentration in the needle washout of fine-needle aspiration (FNA) compared to cytology of suspicious lesions suggestive of culprit parathyroid glands in patients with recurrent or persistent primary hyperparathyroidism (PHPT). Study Design Retrospective review. Methods Patients with recurrent or persistent PHPT, who were referred to one surgeon and underwent FNA of the culprit parathyroid lesion preoperatively, were included in this study. All patients underwent comprehensive neck ultrasound, and suspicious lesions underwent ultrasound-guided FNA by the same surgeon. The aspiration cytology was read by a single dedicated cytopathologist blinded to the PTH washout results. A positive cutoff value for PTH washout concentration was defined as superior to serum PTH level obtained at the same time. The final diagnosis after reoperative surgery was confirmed by the same cytopathologist. Results Twenty-four consecutive patients were included. The mean serum PTH and calcium were 111.5 ± 106.25 pg/mL (normal: 15–65 pg/mL) and 10.8 ± 0.5 mg/dL (normal: 8.6–10.2 pg/mL), respectively. Twenty-two patients (91.6%) had elevated PTH washout concentrations with a positive predictive value (PPV) of 100%. Cytopathology was successful in confirming parathyroid tissue only in seven patients (29%). An adenoma was identified in 19 patients (79.1%); however, five patients (20.8%) were found to have multiglandular disease. Conclusions An elevated PTH washout concentration can help identify culprit parathyroid gland lesions with a high PPV in patients requiring reoperative parathyroid surgery. This diagnostic technique allows for targeted surgical approach in reoperative settings, especially in patients with negative preoperative sestamibi scans. Level of Evidence 4.
TWO MUTATIONS IDENTIFIED IN THE ANDROGEN RECEPTOR OF THE NEW HUMAN PROSTATE CANCER CELL LINE MDA PCA 2A

Purpose: We have characterized the androgen receptor (AR) in a new human prostate cancer cell line, MDA PCa 2a, that has recently been established from a bone metastasis of a patient whose cancer e...
Alate Production of Soybean Aphid (Homoptera: Aphididae) in Minnesota

The soybean aphid, Aphis glycines Matsumura, is a serious pest in Midwestern soybean, Glycine max L. Merrill, and has the potential to colonize a large geographic range throughout a single growing season. Our objectives were to describe colonization patterns on a statewide spatial and temporal scale, examine the changing proportion of winged forms throughout a season, and assess photoperiod as a potential trigger for alate production. In Minnesota, we define initial colonization as the period of time during the early vegetative growth when alates were present and alatoid nymphs were absent on soybean. Initial colonization during 2002 and 2003 was ∼2 wk. On average across Minnesota, summer migrants were first produced when most fields were at the initial flowering stages in 2002. In 2003, an outbreak year, initial detection of summer migrants occurred earlier during vegetative stages before flowering. The significant increase in the proportion of all potential migratory forms (i.e., alatoid nymphs and adults) occurred during the beginning of seed set for both years. During seed set, the mean proportion of alate A. glycines was 0.15 ± 0.04 (SE) in 2002 and 0.16 ± 0.06 in 2003. The mean proportion of alatoid nymph A. glycines was 0.14 ± 0.04 in 2002 and 0.29 ± 0.04 in 2003 during seed set. The total mean proportion of migratory forms was higher when the critical L:D photoperiod was 14.5:9.5 h/d. A regression analysis also indicated the proportion of winged A. glycines increased with decreasing photoperiod.
Multi-robot inverse reinforcement learning under occlusion with interactions

We consider the problem of learning the behavior of multiple mobile robots executing fixed trajectories in a common space and possibly interacting with each other in their execution. The mobile robots are observed by a subject robot from a vantage point from which it can observe a portion of their trajectories only. This problem exhibits wide-ranging applications and the specific application we consider here is that of the subject robot who desires to penetrate a simple perimeter patrol by two interacting robots and reach a goal location. Our approach extends single-agent inverse reinforcement learning (IRL) to a multi-robot setting and partial observability, and models the interaction between the mobile robots as equilibrium behavior. IRL provides weights over the features of the robots' reward functions, thereby allowing us to learn their preferences. Subsequently, we derive a Markov decision process based policy for each other robot. We extend a predominant IRL technique and empirically evaluate its performance in our application setting. We show that our approach in the application setting results in significant improvement in the subject's ability to predict the patroller positions at different points in time with a corresponding increase in its successful penetration rate.
IV. The Rôle of Congress and Public Opinion in Formulating Foreign Policy

There is a popular expectation in the United States that the peace settlement of the major United Nations will be as effectively and loyally executed by the United States as by Great Britain and Soviet Russia. This over-confidence of the American people in the prowess of their President is partly due to: (1) the successful conduct of the war, (2) the popular credence placed in the Chief Executive as national leader in time of war, (3) the immense personal prestige of President Roosevelt and his Secretary of State, Cordell Hull, and (4) the belief that, in case the November election should bring the Republican party into control of the White House, Governor Dewey would continue with vigor the Rooseveltian policy of full participation and leadership on the part of the United States. A warning that the American Senate might shatter this peace settlement was sounded by Senators Arthur H. Vandenberg and Robert A. Taft and other somewhat isolation-minded Republicans in September, 1943, in the Mackinac Declaration. The “constitutionalism” proposed by this declaration meant nothing else than that the peace settlement must be in the form of a treaty which would require the consent of two-thirds of the members of the American Senate. Senators Vandenberg and Taft controlled the resolutions committee of the Republican national convention in July, 1944, with the result that the Republican platform concluded its proposal regarding the peace settlement with the following pronouncement: “Pursuant to the Constitution of the United States, any treaty or agreement to attain such [international] aims made on behalf of the United States with any other nation or association of nations, shall be made only by and with the advice and consent of the Senate of the United States provided two-thirds of the Senators present concur.”
TRICHODERMA SPP.: GROWTH RATES AND ANTAGONISM TO PHELLINUS WEIRII IN VITRO

Seventy isolates representing six species of Trichoderma were tested for linear growth rates at five temperatures (5-25 C). Growth rate varied substantially within and among species. Multivariate procedures were used to distinguish species on the basis of their growth rates. The ability of nine isolates to kill Phellinus weirii was tested in vitro at 10 and 20 C. Isolates of T. viride, T. polysporum, and T. harzianum were more antagonistic to P. weirii than were isolates of the other three species. The T. harzianum isolate killed P. weirii fastest at 20 C, whereas the T. viride and T. polysporum isolates acted most rapidly at 10 C. Techniques used here to assay antagonism can be extended to test more isolates, both in vitro and in the field.
Continued Fractions and Modified Continued Fractions for Certain Series

(1938). Continued Fractions and Modified Continued Fractions for Certain Series. The American Mathematical Monthly: Vol. 45, No. 6, pp. 352-362.
Optical Coherence Tomography Angiography in Choroideremia: Correlating Choriocapillaris Loss With Overlying Degeneration

Importance Novel therapies for choroideremia, an X-linked recessive chorioretinal degeneration, demand a better understanding of the primary site(s) of cellular degeneration. Optical coherence tomography angiography allows for choriocapillaris (CC) imaging. We compared the extent of structural alterations of the CC, retinal pigment epithelium, and photoreceptors with multimodal imaging. Observations In a clinical case series conducted from September 15, 2014, through February 5, 2015, 14 eyes of 7 male patients with choroideremia (median age, 34 years [interquartile range, 15-46 years]; age range, 13-48 years), 4 eyes of 2 women with choroideremia carrier state (both in mid-50s), and 6 eyes of 6 controls (median age, 42.5 years [interquartile range, 33-55 years]; age range, 24-55 years) underwent multimodal imaging with optical coherence tomography angiography and electroretinography. The mean (SD) macular CC density was 82.9% (13.4%) in patients with choroideremia, 93.0% (3.8%) in female carriers, and 98.2% (1.3%) in controls. The mean (SD) CC density in affected eyes was higher in regions with preserved (92.6% [5.8%]) vs absent (75.9% [12.6%]) ellipsoid zone (mean difference, 16.7%; 95% CI, 12.1% to 21.3%; P r = −0.62; 95% CI, −0.84 to −0.19; P r = −0.71; 95% CI, −0.91 to −0.27; P Conclusions and Relevance These findings suggest that regional changes in CC density correlate with photoreceptor structural alterations in choroideremia. Although closely coupled, the results suggest that retinal pigment epithelium loss is more extensive than photoreceptor loss.
The Study of On-site Metering and Calibration of Fully Digital Power Metering System

Currently in Digital Substation,the output of Electronic Transformer is digital signal frame basic on IEC61850-9-1,and the Digital Power Meter calculates the power directly according to the digital signal frame.But in traditional substation,the output of traditional Transformer is analog voltage and current signals,the traditional Power Meter convert these analog signals into digital signal and then calculate the power.So compared with the traditional Transformer and Power Meter,the principle and interface of Electronic Transformers and Digital Meter have made fundamental changes.This gives the calibration of Electronic Transformers and Digital Meter new demands,the traditional calibration equipment cant’ meet the requirements.To address this problem,this paper presents a fully digital power metering system calibration method,calibrate the fully error of digital power metering system which consisted of Electronic Transformer and Digital Meter.According to this method,we make on-site calibration firstly in our country and obtained satisfactory results.
Investigation on the content of iodine in drinking water in Hongkou District of Shanghai City

[Objective]To investigate the iodine contents and its distribution status in the drinking water in Hongkou District of Shanghai City,and provide scientific basis and data support for the government to make or perfect policies related to iodine compensation.[Methods]Covering all communities in the range of Hongkou District,including Quyang,Tilanqiao,Jiaxing,Guangzhou,Jiangwan,Liangcheng,North Sichuan,and Ouyang Community,and all subordinating residents' committees,drinking water samples were collected from randomly selected households which belonged to the above mentioned residents' committees,the cerium sulfate catalytic spectrophotometric method was used to measure and analyze the iodine contents of the water samples.[Results] A total of 448 water samples were collected,the median number was 4.64 μg/L,the contents of iodine in water ranged between 0.06-17.98 μg/L.The number for water samples whose iodine content 10 μg/L was 443,accounted for 99% of the total samples;while the number for water samples whose iodine content≥10 μg/L was just 5,representing 1% of the total samples;There was no significant difference(P0.05) between all communities in water iodine frequency distribution.[Conclusion]According to GB 16005-1995 Iodine Deficiency Disease Endemic Criteria,Hongkou District is iodine deficient area;the distribution of iodine contents in residents' drinking water is averagely.Artificial iodine compensation method,such as insisting adding iodine to celery salt,may be an economical and effective way to prevent iodine deficiency disease for this district.
Intravenous Lipid Emulsion Therapy for Bromethalin Toxicity in a Dog

Bromethalin is a central nervous system toxin currently incorporated into several different rodenticides. In 2008, the EPA requested that manufacturers phase out second-generation anticoagulant rodenticides. In response, manufacturers began to increase production of bromethalin-based rodenticides. It is likely that pet exposure to bromethalin will increase in the future. Bromethalin has no known antidote and tends to deposit in fat. Intravenous lipid emulsions (ILEs) are being used with increasing frequency in both human and veterinary medicine to treat numerous acute systemic toxicities. A 4 yr old spayed female Pit bull terrier was presented following witnessed ingestion of bromethalin rodenticide by the owners. Decontamination was unsuccessful and ILE was started. Serum was frozen at -80°C before and 1 hr after completion of ILE. In rats, the half-life of desmethylbromethalin, the toxic metabolite, has been reported at 5.6 days and 6 days, and it is likely to be similar in dogs. The only intervention between the pre-lipid serum sample and the post-lipid serum sample was the administration of ILE, and the serum desmethylbromethalin levels were reduced by 75% (from 4 ppb to 1 ppb) during this time. To the authors' knowledge, this is the first report describing treatment of bromethalin ingestion with ILE.
Additional studies on the nature of big big gastrin.

Analyses by electrophoresis, ultracentrifugation, and gel filtration extend our previous finding of a new form of immunoreactive gastrin, designated as "big big gastrin" (BBG). This component elutes in the void volume of Sephadex G-50 gel filtration, has the same ultracentrifugal sedimentation velocity as human growth hormone, and an electrophoretic mobility on starch gel just in advance of serum albumin. Trypsin converts BBG to smaller hormonal forms down to and including heptadecapeptide-like gastrin. BBG is a major fraction of total gastrin immunoreactivity in normal human, canine, and porcine plasmas in the nonstimulated state and is the only form detectable in a gastrectomized patient post-Billroth II. It is not detectably stimulated by feeding and comprised less than about 2% of the total immunoreactivity in a Zollinger-Ellison tumor or in the plasma of patients with Zollinger-Ellison syndrome, pernicious anemia, or who were gastrin hypersecretors. The biologic significance of BBG has not as yet been evaluated. A family of immunoreactive gastrins with elution volumes between BBG and the previously described big gastrin has been detected as a minor component of an extract of a Zollinger-Ellison tumor as well as after tryptic digestion of BBG. It has not been determined whether this family of gastrins is significant in vivo or simply represents degradation products of BBG.
Dosimetrically Determined Prescribed Activity of 131I for the Treatment of Metastatic Differentiated Thyroid Carcinoma

In the absence of definitive studies relating 131I prescribed activity to outcomes, the selection of a specific prescribed activity of 131I to treat metastatic thyroid carcinoma is problematic, and several approaches have historically been adopted. These include empiric fixed prescribed activity and prescribed activity based on dosimetric approaches specific for each patient. This chapter reviews the rationale and technique for “dosimetrically determined” prescribed activity of 131I for the treatment of metastatic thyroid carcinoma and discusses (1) the alternatives for the selection of a prescribed activity, (2) the two major dosimetric approaches for determining 131I prescribed activity, (3) several modifications of these approaches that have been implemented over time, (4) an overview of the literature regarding the results, and (5) recommendations for patient management and future research. This review does not address the use of dosimetrically determined prescribed activity of 131I for the initial (postoperative) remnant ablation of normal thyroid remnant tissue or adjuvant treatment.
Acquisition of Long-Term Visual Representations: Psychological and Neural Mechanisms

How do we so rapidly achieve an organized, coherent visual percept of our superficially chaotic world? One way of reducing the complexity of the input is to take advantage of the statistical regularities and regular co-occurrences between aspects of objects and between objects and their spatial locations. In this chapter, converging data obtained from normal and brain-damaged individuals, as well as from single unit recording studies in monkeys, are presented, all of which address the psychological and neural mechanisms associated with statistical learning. The first section deals with learning regularities associated with particular spatial locations, presumably a function of the dorsal ‘where’ stream and data from normal individuals and from patients with hemispatial neglect are presented. The second section reports the findings from human and monkey studies, which show how statistical contingencies of the visual environment are reflected in behavior and how neurons in monkey inferotemporal cortex, the ventral “what” stream, appear to mediate these statistical effects. Taken together, using data from a variety of methodologies, this work attests to the flexibility and robustness of the visual system and sheds light on the way in which perceptual organization operates to convert raw input into long-term visual representations.
Elec-Tech, Inc. (A1)

The purpose of this case is to explore the strategic options that open in an industry under conditions of deregulation. Excerpt UVA-E-0139 Elec-Tech, Inc. (A1) Jill Martin surveyed the stack of reports on her desk and sighed. After weeks of review, countless meetings, and hours spent poring over various market surveys, regulatory updates, analysts' reports, and reams of related data, she was still no closer to developing a set of recommendations for her boss, F. R. Roshus. Roshus was the newly appointed division manager for Elec-Tech America, one of the largest independent power producers in the United States. Roshus's appointment signaled Elec-Tech International's renewed focus on the U.S. market after recent years spent concentrating its efforts on acquiring or building electric power facilities in developing nations. Given the current momentum for deregulation of the electric power industry in the United States, the time seemed right to re-evaluate Elec-Tech's strategy in its home country. However, given the patchwork of unfolding state and federal deregulation, it was unclear which strategic path made the most sense for Elec-Tech. Martin poured another cup of coffee and resigned herself to spending another long night at the office reviewing the stack of materials on her desk. Elec-Tech Operations Since its incorporation in 1983, Elec-Tech (ET) gained a reputation for building and operating electric power facilities that were significantly cleaner, safer, and more reliable than the industry average. The company became an industry leader in repowering older, less-efficient facilities as it transformed them into extremely efficient, low-cost, modern power plants. The company also became expert in the development and construction of greenfield plants although these were primarily located in emerging markets. In 1995, ET and its subsidiaries and affiliates sold electricity to customers in eight countries—the United States, Argentina, Brazil, India, Pakistan, Uganda, China, and Taiwan. Its 17 plants represented 2,076 megawatts (MW) and over $ 2 billion of total assets. . . .
Identifying Political Topics in Social Media Messages: A Lexicon-Based Approach

In this paper, we introduce a lexicon-based method for identifying political topics in social media messages. After discussing several critical shortcomings of unsupervised topic identification for this task, we describe the lexicon-based approach. We test our lexicon on candidate-generated campaign messages on Facebook and Twitter in the 2016 U.S. presidential election. The results show that this approach provides reliable results for eight of nine political topic categories. In closing, we describe steps to improve our approach and how it can be used for future research on political topics in social media messages.
Greening Dis-Ability

This chapter is the first essay ever to connect together ecology, dis-ability, and animal advocacy, couched in terms of interlocking social constructions and the interwoven web of interdependent global life. Both concepts of “the natural world” and “disability” will be viewed here as socially constructed entities. I suggest that for the current global ecological crisis to transform into a more sustainable global community, including nonhuman animals, the field of environmental studies needs to engage in a discussion of colonization and domination. Next, I explain and deconstruct the meaning of disability.
Isoreticular expansion of polyMOFs achieves high surface area materials

The concept of isoreticular chemistry has become a core principle in metal–organic framework (MOF) materials. Isoreticular chemistry has shown that organic ligands of different sizes, but with a common geometry/symmetry can be used to generate MOFs of related topologies, but with expanded pore sizes and volumes. In this report, polymer–MOF hybrid materials (polyMOFs) with a UiO (UiO = University of Oslo) architecture are shown to adhere to the principle of isoreticular expansion, generating polyMOFs with large surface areas and enhanced stability.
Maternal Emotion Socialization and Child Outcomes among African Americans and European Americans

Mothers’ emotion socialization practices are very important for children’s later outcomes; however, we know very little about how these practices may lead to different outcomes for European American (EA) and African American (AA) children. In the current study, maternal emotion socialization practices were investigated in relation to child emotion-related outcomes in 122 pairs of mothers and preschool-age children, and differences in associations were examined for EA and AA families. Mothers were assessed for their expressions of positive emotion with their child and their responses to their child’s negative emotions, including support of sadness/fear and magnification of anger, when children were 3. Children were assessed for their expression of positive emotion with their mother and their internalizing and externalizing problem behaviors when they were 4. When ethnicity was included as a moderator, results revealed that when AA mothers expressed more positive emotion, their children were also more positive 1 year later. Additionally, as AA mothers provided greater support for their children’s sadness/fear, these children tended to have fewer later internalizing problems. Finally, when AA mothers responded with more magnification of their children’s anger, these children tended to have greater internalizing and externalizing problems 1 year later. These associations were not found for EA families. Results highlighted differential effects based on the type of support provided by mothers and the role that mothers played in encouraging or suppressing their child’s expressions. The overall findings highlight the need to consider maternal emotion socialization from a culturally-informed perspective.
Retinal signs and 20-year cognitive decline in the Atherosclerosis Risk in Communities Study

Objective To test the hypothesis that retinal vascular signs are associated with greater cognitive decline over 20 years in 12,317 men and women 50 to 73 years of age at baseline. Methods A composite cognitive score was created with 3 neuropsychological tests measured at 3 time points (1990–1992 to 2011–2013). Retinal signs were measured with fundus photography (1993–1995). Differences in cognitive change by retinal signs status were estimated with linear mixed models. Cognitive scores were imputed for living participants with incomplete cognitive testing. Results In multivariable-adjusted analyses that controlled for attrition, loss of vascular integrity (retinopathy and its components) was associated with greater 20-year decline (difference in 20-year cognitive change for moderate/severe vs no retinopathy −0.53 SD, 95% confidence interval −0.74 to −0.33). Estimated differences were similar in participants with and without diabetes mellitus and in white and black participants. Conclusions Retinopathy was associated with accelerated rates of 20-year cognitive decline. These findings support the exploration of more sensitive measures in the eye such as optical coherence tomography angiography, which may provide surrogate indexes of microvascular lesions relevant to cognitive decline in older adults.
Clinical and Ethical Considerations for Delivering Couple and Family Therapy via Telehealth

Studies have generally supported telehealth as a feasible, effective, and safe alternative to in-office visits. Telehealth may also be of particular benefit to couples/families interested in relational treatments, as it addresses some of the barriers that may be more prominent for families, such as childcare and scheduling difficulties. Therapists interested in expanding their practice to include telehealth should understand ethical and practical considerations of this modality. This article discusses areas unique to the delivery of telehealth to couples and families. Each broad domain is then elaborated upon with case examples from actual clinical practice and specific recommendations for addressing potential difficulties. Authors recommend further empirical research examining differences in modality outcome, as well as feasibility of the suggestions proposed here.
Effects of aerobic training with and without weight loss on insulin sensitivity and lipids.

Purpose The purpose of this study is to evaluate the effect of exercise training with modest or greater weight loss (≥3%) or not (<3%) on insulin sensitivity, lipoprotein concentrations, and lipoprotein particle size in overweight and obese participants. Methods Adults (N = 163, body mass index: 25–37 [kg/m2]) participated in 8 months of exercise training. Insulin sensitivity, lipid concentrations, lipid particle size and other cardiometabolic variables were measured at baseline and follow-up. Participants were categorized by whether they achieved at least modest weight loss (≥ 3%) or not (<3%) following the intervention. Results A greater improvement in insulin sensitivity was observed in adults performing exercise training with at least modest weight loss (2.2 mU·l-1 ·min -1, CI: 1.5 to 2.8) compared to those who did not (0.8 mU·l-1 ·min -1, CI: 0.5 to 1.2). Similar results were observed for acute insulin response, triglycerides, non-HDL cholesterol concentration, low density lipoprotein (LDL) particle size and high density lipoprotein (HDL) particle size (p<0.05), when all exercise groups were combined. No significant results across weight loss categories were observed for LDL, HDL, glucose, or insulin levels. Conclusion The present study suggests that aerobic exercise combined with at least modest weight loss leads to greater improvements in insulin sensitivity, triglycerides as well as other non-traditional lipid risk factors (non-HDL cholesterol, HDL/LDL particle size). Clinicians should advocate patients who are overweight/obese to exercise and obtain modest weight loss for improved cardiovascular benefits.
Digestion Coupled with Programmed Thermal Analysis for Quantification of Multiwall Carbon Nanotubes in Plant Tissues

The rapidly growing application of carbon nanotubes (CNTs) for industry and consumer products will inevitably lead to their accumulation in the environment. Protection of food safety from contamination by CNTs and best-practice management of agricultural application of CNTs require quantification of CNTs in agricultural plants. Herein, a novel method of digestion coupled with programmed thermal analysis (PTA) was developed for quantitative analysis of multiwall CNTs (MWCNTs) in plant (lettuce) tissues. MWCNT-bound carbon was linearly correlated with elemental carbon (EC) detected by PTA, including EC1 (58.5%) (evolved at 580 °C) and EC2 (41.5%) (evolved at 740 °C), corresponding to less stable and stable carbon, respectively. The background plant materials could interfere with EC quantification of CNTs, as a substantial fraction of the plant biomass was charred during the thermal analysis. Sequential digestion with concentrated nitric acid (HNO3) and sulfuric acid (H2SO4) effectively minimized the interfe...
Fifty Years of Steroid Treatment of Myasthenia Gravis (P6.453)

Objective: In 1969 Dr. R.A. Utterback and I, Dr. Charles A. Cape, determined that long-term treatment of myasthenia gravis using steroids was effective. This is a follow-up of those patients plus those previously reported in NEUROLOGY in 1972. This paper documents the effectiveness and safety of long-term treatment with streroids of myasthenia gravis patients. Background: Objective: To determine the effectiveness of sixteen of my myasthenia gravis patients who were treated with steroids for up to fifty years and the effect of using long-term steroids if the dosage is properly adjusted. Methods: Follow-up of sixteen of my patients treated for up to fifty years with ACTH or prednisone. Design/Methods: In 1969 and again in 1972 my colleagues and I established that long-term therapy with corticosteroids could maintain the improvement achieved after an intensive course of ACTH. This report provides a 50 year follow-up of these previously reported 16 patients. Results: Four patients are living who have been treated for 34, 45, 45, & 50 years. Eight patients died that had been treated from 4–44 years. They died from respiratory disease (3), cancer (3), & unknown cause (2). Four patients were lost to follow-up. The usual side effects occurred, but were controlled or alleviated by spacing the ACTH injections or the prednisone dosage out from daily, to every other day, to every third, fourth, fifth, sixth or seventh day. Conclusions: Maintenance ACTH, prednisone, or other autoimmune therapy has obviated most of the disadvantages of repeated intensive courses of therapy. It avoids the recurrent crisis and hospitalization with intensive treatment. Maintenance therapy allowed many patients to reduce or discontinue their anticholimesterase medications. Conclusion: Long-term, maintenance, corticosteroid therapy is effective and safe if properly used for many years. The follow-up also shows that long-term steroids can be used for treatment of chronic diseases if the dosage is properly adjusted Disclosure: Dr. Cape has nothing to disclose.
Learning New Procedures

Learning a new technique after training is challenging. There are many obstacles to overcome. Creating a plan and writing down your strategy can help to insure success. In the end, you have to be honest with yourself, your patients, and your staff that you are doing something new and there will be learning points along the way for everyone involved. The chapter gives some helpful advice for how to start something new in your practice.
Leveraging Hypomethylating Agents for Better MDS Therapy

Myelodysplastic syndrome (MDS) is a clinically and molecularly heterogeneous disease, which primarily occurs in older adults. Although hypomethylating agents have survival benefit and are the current standard of care, many MDS patients will not garner a response from therapy. For those who do respond, most responses are not durable, and the only hope for a cure is allogeneic stem cell transplant. New therapies to improve outcomes are urgently needed. Clinical trials combining standard hypomethylating agents with novel experimental agents are underway in an effort to improve clinical outcomes in MDS patients. Several of these small molecules have demonstrated the ability to augment the response rates of hypomethylating agents alone, including complete remission rates, in both the front line and refractory settings. Combination approaches utilizing hypomethylating agents and novel-targeted therapies have demonstrated the ability to improve response rates in MDS patients in both the front line and salvage settings, and thus may change the standard of care.
Wnt Signaling in Vascular Eye Diseases

The Wnt signaling pathway plays a pivotal role in vascular morphogenesis in various organs including the eye. Wnt ligands and receptors are key regulators of ocular angiogenesis both during the eye development and in vascular eye diseases. Wnt signaling participates in regulating multiple vascular beds in the eye including regression of the hyaloid vessels, and development of structured layers of vasculature in the retina. Loss-of-function mutations in Wnt signaling components cause rare genetic eye diseases in humans such as Norrie disease, and familial exudative vitreoretinopathy (FEVR) with defective ocular vasculature. On the other hand, experimental studies in more prevalent vascular eye diseases, such as wet age-related macular degeneration (AMD), diabetic retinopathy (DR), retinopathy of prematurity (ROP), and corneal neovascularization, suggest that aberrantly increased Wnt signaling is one of the causations for pathological ocular neovascularization, indicating the potential of modulating Wnt signaling to ameliorate pathological angiogenesis in eye diseases. This review recapitulates the key roles of the Wnt signaling pathway during ocular vascular development and in vascular eye diseases, and pharmaceutical approaches targeting the Wnt signaling as potential treatment options.
Scalable Collaborative Filtering Based on Splitting-Merging Clustering Algorithm.

Recommender systems apply information filtering technologies to identify a set of items that could be of interest to a user. Collaborative filtering (CF) is one of the most well-known successful filtering techniques in recommender systems and has been widely applied. However the usual CF techniques face issues that limit their application, especially in dealing with highly sparse and large-scale data. For instance, CF algorithms using the k-Nearest Neighbor approach are very efficient in filtering interesting items to users but in the same time they require a very expensive computation and grow non-linearly with the number of users and items in a database. To address this scalability issues, some researchers propose to use clustering methods. K-means is among the well-known clustering algorithms but has the shortcomings of dependency on the number of the clusters and on the initial centroids, which lead to inaccurate recommendations and increase computation time. In this paper, we will show by comparing with K-means based approaches how a clustering algorithm called K-means+ that considers the statistical nature of data can improve the performances of recommendation with reasonable computation time. The results presented that predictions of substantially better quality are obtained with the proposed K-means+ method. These results also provide significant evidences that the proposed Splitting-Merging clustering based CF is more scalable than the conventional one.
Pancreatic Injuries in Abdominal Trauma in US Adults: Analysis of the National Trauma Data Bank on Management, Outcomes, and Predictors of Mortality.

Background and Aims:Traumatic pancreatic injury is associated with high morbidity and mortality rates, and the management strategies associated with the best clinical outcomes are unknown. Our aims...
1249-P: Development and Validation of a Measure for Appropriateness of Glucose-Lowering Therapy

Current diabetes quality indicators do not reflect considerations of clinical complexity, hypoglycemia risk, and treatment burden in identifying optimal therapeutic regimens and targets. Based on existing evidence and input from patients and clinician, payer, and quality measurement experts, we developed a metric that incorporates HbA1c level, comorbidity burden, and number/type of glucose lowering medications (Table) to classify patients as potentially overtreated, undertreated, or appropriately treated. Measure was tested in a national cohort of commercial and Medicare Advantage enrollees with diabetes using the OptumLabs® Data Warehouse. Among 215,429 adults ≥18 years (mean 65 years, 49.6% female, 59.4% white, 4.2% type 1 diabetes, 12.1% clinically complex, 52.7% with HbA1c Implementation of this measure to minimize over- and under-treatment through a patient-centered approach to glucose lowering therapy is planned. Disclosure R.G. McCoy: None. K.J. Lipska: Consultant; Self; Health Services Advisory Group (HSAG). Research Support; Self; National Institute on Aging. Other Relationship; Self; Centers for Medicare and Medicaid Services. H. Van Houten: None. N. Shah: None. Funding American Association of Retired Persons; OptumLabs; National Institute of Diabetes and Digestive and Kidney Diseases (K23DK114497)
Masculinity and Narrative Voice in Aphra Behn's Love Letters between a Nobleman and his Sister

Critics have often remarked on the character and formal instabilities in Aphra Behn's Love Letters between a Nobleman and his Sister, especially as it relates to the titular sister, Silvia. Silvia'...
Bacteriuria in a Patient with Incident Delirium

New-onset delirium can be a sign of life-threatening illness. Careful evaluation and follow-up are essential if the patient is sick or the delirium is persistent. Delirium is usually self-limited, however, especially among otherwise well older people with limited cognitive reserve. In such patients, asymptomatic bacteriuria, meaning a positive urine culture without urinary symptoms, is highly prevalent and so will commonly accompany delirium by chance alone. There is no evidence that treating asymptomatic bacteriuria improves delirium outcomes. Expert opinion consistently recommends against this practice. When minor perturbations cause transient cognitive dysfunction, treatment of “UTI” enjoys the same success as other treatments for self-limited illnesses. This is often interpreted as proof that “UTI” caused the delirium. Repeated attempts to sterilize the urine may ensue. But urine is never sterile. Acknowledgment of the urinary microbiome should encourage recalibration of the harm/benefit analysis for antibiotic treatment.
An Educational Framework for Healthcare Facility Management: Preparing Future Professionals

ABSTRACT Purpose— The purpose of this research is to better understand learning outcomes essential for college students to be effective entry-level healthcare facility managers, establishing a heal...
Exploring Dimensions of Well-Being among Spouses of Active-Duty Service Members

EXPLORING DIMENSIONS OF WELL-BEING AMONG SPOUSES OF ACTIVEDUTY SERVICE MEMBERS By Lisa A. Gray, L.C.S.W. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University Virginia Commonwealth University, 2015 Major Director: Sarah Kye Price PhD, MSW Associate Professor, School of Social Work During an era when the United States has been engaged in the longest waging wars in U.S. history, military families have been exposed to extraordinary amounts of stress and have had to learn to adapt in a culture where repeated deployments, recurrent family separations, and frequent relocations have become the norm. A surge in research in recent years on the families of Service members has brought increased attention to the unique challenges and demands of spouses, raising concerns about how to best meet their needs. Despite the increased attention, few studies have focused on spousal well-being. Acknowledging this lack of research, the present dissertation study utilized a mixed-methods approach to explore various dimensions of well-being, as directly experienced by spouses of active-duty military personnel. Data was collected from a web-based survey completed by 300 spouses of active-duty Service members. Quantitative data included a wide range of demographic, family, military lifestyle, and service utilization questions along with a battery of standardized instruments measuring various risk and protective factors, which represent components of well-being. Qualitative data were collected from four open-ended questions and analyzed thematically. Qualitative and quantitative components were corroborated in the final analysis. Results of the study found significant differences in well-being scores among subsamples of participants divided by employment status, race, and Service member rank. However, subsamples divided on the basis of having children, education level, and Service member combat deployment history did not result in significantly different well-being scores. Separate hierarchical regression analyses were performed on the outcome scores for each component of well-being (social, mental, and physical). The findings revealed that selected risk & protective factor variables were significant predictors within each model. On the other hand, sociodemographic characteristics only added to the predictive power of outcomes scores in the mental component of well-being. Qualitative findings included data on participants’ perspectives of the rewards and challenges of military life, the impact of the military lifestyle on parenting experiences, and advice to spouses new to the military lifestyle. Implications and limitations of this study, as well as suggestions for future research to enhance the well-being of military spouses, are discussed.