cssi/SciSciGPT-SciSciNet huggingface dataset:
Intelligent Positioning of Mobile Cranes for Steel Erection

: The crane is the single most important equipment cost item required for erecting structural steel. Each time the crane moves to a new location, equipment time and labor time is lost. This research presents a computerized analysis method to minimize the number of moves required by a mobile crane to erect single story steel structures. The production rule system finds the optimum path for the crane and determines the steel erection sequence. Artificial intelligence techniques are employed to develop the production rule system. They system finds the optimum path for the crane and determines the steel erection sequence. The production rule system consists of three basic components. The first is a knowledge representation which describes the building and crane geometry. Second is the production rules for positioning the crane and sequencing the steel erection. These rules were structured from interviews with steel erectors and converted to logic based rules used in the program. Third is the control strategy which analyzes the various combinations of crane positions. The result is a microcomputer based Prolog program called PRECISE. This program finds the optimal crane positions and the structural members erected from each crane position.
Sentinel lymph node dissection provides axillary control equal to complete axillary node dissection in breast cancer patients with lobular histology and a negative sentinel node

Abstract Objective Invasive lobular carcinoma (ILC) presents special challenges to treating physicians because of the diffuse infiltrative growth pattern. As sentinel lymph node dissection (SLND) is rapidly replacing axillary lymph node dissection (ALND) in the management of patients with early-stage breast cancer, we sought to evaluate the safety of SLND in providing axillary control in breast cancer patients with lobular histology and a negative sentinel node. Methods We identified 239 patients with T1-2,N0,M0 lobular breast cancer from the prospective databases of 2 institutions; all were treated between March 1994 and December 2003. Results A total of 202 patients had SLND and 37 had SLND followed by ALND. There was no significant difference between the 2 groups with respect to tumor size, presence of lymphovascular invasion, estrogen receptor (ER)/progesterone receptor (PR) and HER-2/neu status, type of breast surgery, margin status, or nuclear grade. Use of chemotherapy, radiation, and hormonal therapy was not significantly different between groups. At a median follow-up of 48 months in the ALND group and 26 months in the SLND group (range 6 to 80 months), none of the 202 patients in the SLND group had experienced an axillary recurrence, while 2 (5.4%) of the 37 patients who underwent ALND had experienced an axillary recurrence. Conclusions SLND provided axillary control equivalent to that of ALND for patients with lobular breast cancer. SLND alone appears to be adequate axillary management of patients with lobular breast cancer and a negative sentinel node.
Coactivation of β-Adrenergic and Cholinergic Receptors Enhances the Induction of Long-Term Potentiation and Synergistically Activates Mitogen-Activated Protein Kinase in the Hippocampal CA1 Region

Interactions between noradrenergic and cholinergic receptor signaling may be important in some forms of learning. To investigate whether noradrenergic and cholinergic receptor interactions regulate forms of synaptic plasticity thought to be involved in memory formation, we examined the effects of concurrent beta-adrenergic and cholinergic receptor activation on the induction of long-term potentiation (LTP) in the hippocampal CA1 region. Low concentrations of the beta-adrenergic receptor agonist isoproterenol (ISO) and the cholinergic receptor agonist carbachol had no effect on the induction of LTP by a brief train of 5 Hz stimulation when applied individually but dramatically facilitated LTP induction when coapplied. Although carbachol did not enhance ISO-induced increases in cAMP, coapplication of ISO and carbachol synergistically activated p42 mitogen-activated protein kinase (p42 MAPK). This suggests that concurrent beta-adrenergic and cholinergic receptor activation enhances LTP induction by activating MAPK and not by additive or synergistic effects on adenylyl cyclase. Consistent with this, blocking MAPK activation with MEK inhibitors suppressed the facilitation of LTP induction produced by concurrent beta-adrenergic and cholinergic receptor activation. Although MEK inhibitors also suppressed the induction of LTP by a stronger 5 Hz stimulation protocol that induced LTP in the absence of ISO and carbachol, they had no effect on LTP induced by high-frequency synaptic stimulation or low-frequency synaptic stimulation paired with postsynaptic depolarization. Our results indicate that MAPK activation has an important, modulatory role in the induction of LTP and suggest that coactivation of noradrenergic and cholinergic receptors regulates LTP induction via convergent effects on MAPK.
The Role of Topotecan in the Treatment of Small Cell Lung Cancer.

Topotecan is a chemotherapeutic agent that is active in the treatment of small cell lung cancer (SCLC). As a first-line agent in chemotherapy-naive patients with extensive disease SCLC, topotecan has a 39% response rate. As a second-line drug in SCLC patients with “sensitive” disease and “refractory” disease, the response rate is greater than 38% and less than 10%, respectively. The combination of topotecan and paclitaxel exhibits a promising overall response rate of 92% in chemotherapy-naive patients with extensive disease SCLC. Further studies are warranted with topotecan used in combination with other agents, including radiation therapy in patients with SCLC. The Oncologist 1998;3:11-14
Endothelial nitric oxide synthase uncoupling and microvascular dysfunction in the mesentery of mice deficient in α-galactosidase A

A defect in the gene for the lysosomal enzyme α-galactosidase A (Gla) results in globotriaosylceramide (Gb3) accumulation in Fabry disease and leads to premature death from cardiac and cerebrovascu...
Multi-Detection Events, Probability Density Functions, and Reduced Location Area

Several efforts have been made in the Comprehensive Nuclear-Test-Ban Treaty (CTBT) community to assess the benefits of combining detections of radionuclides to improve the location estimates available from atmospheric transport modeling (ATM) backtrack calculations. We present a Bayesian estimation approach rather than a simple dilution field of regard approach to allow xenon detections and non-detections to be combined mathematically. This system represents one possible probabilistic approach to radionuclide event formation. Application of this method to a recent interesting radionuclide event shows a substantial reduction in the location uncertainty of that event.
No Association between a Tetranucleotide Repeat Polymorphism of CYP19 and Prostate Cancer

The CYP19 gene encodes the enzyme aromatase, which plays a key role in the conversion of androgen to estrogen. The prostate is influenced by estrogen from peripheral sources as well as through aromatase activity in its stroma ([1][1]). There is evidence of elevated levels of aromatase activity and
Laboratory Studies on the Adult Behavior of Conophthorus coniperdus (Coleoptera: Scolytidae). IV. Responses to Temperature and Humidity

The white-pine cone beetle, Conophthorus coniperdus (Schwarz), is able to avoid flooding by movement within the overwintering cone. There is a general increase in over-all activity with increasing temperature in both wet and dry air. At the highest temperature, the insects are inactive in dry air. Maximum walking speed is attained at 40° C in dry air and at 35° in moist air. In a temperature gradient, the insects settle at a temperature of 30° in both moist and dry air. In a humidity-choice apparatus, the moist side is chosen except when both sides are comparatively dry, in which case the insects are not responsive to humidity differences.
Anterior Cruciate Transection/Disruption Models of Post-Traumatic Arthritis

The anterior cruciate ligament (ACL) plays a critical role in knee stability, and clinically, ACL tears greatly increase the risk for post-traumatic arthritis. In this regard, animal models of ACL transection or disruption have been developed using a variety of species, including dogs, sheep, cats, rabbits, guinea pigs, rats, and mice. These models have used different techniques for disrupting the function of the ACL, including open surgery, stab incision, arthroscopic transection, and noninvasive joint loading. The outcome measures of these studies have included characterization of the ensuing effects on the articular cartilage, synovium, genetic markers, and biomarkers, and have provided a means of testing different therapeutic interventions. In summary, animal models of ACL injury provide repeatable and relatively straightforward means of reproducing many of the characteristics of human PTA, on a more rapid time frame. Here we review the animal models used for studying post-traumatic arthritis, and discuss the potential advantages and disadvantages of different animals and approaches.
The Revised Children's Manifest Anxiety Scale-Second Edition Short Form: Examination of the Psychometric Properties of a Brief Measure of General Anxiety in a Sample of Children and Adolescents.

The psychometric properties of a new, brief measure, the Revised Children’s Manifest Anxiety Scale–Second Edition (RCMAS-2) Short Form, were examined in a sample of 1,003 U.S. elementary and secondary students. The RCMAS-2 Short Form consists of the first 10 items of the RCMAS-2. The results of confirmatory factor analysis indicated that the modified one-factor model provided an adequate fit for students in Grades 2 to 12. The results of tests of measurement invariance supported configural, weak, and strong invariance of the RCMAS-2 Short Form across gender and configural, weak, and partial strong invariance of the RCMAS-2 Short Form across age. Gender and age differences were also examined on the RCMAS-2 Short Form. The results of latent mean analyses indicated that adolescents (ages 12-19) and females had significantly higher factor means than children (ages 7-11) and males, respectively, on the RCMAS-2 Short Form. Moderate correlations between the RCMAS-2 Short Form scores and scores of measures of tes...
Work-related fatal motor vehicle traffic crashes: Matching of 2010 data from the Census of Fatal Occupational Injuries and the Fatality Analysis Reporting System

Motor vehicle traffic crashes (MVTCs) remain the leading cause of work-related fatal injuries in the United States, with crashes on public roadways accounting for 25% of all work-related deaths in 2012. In the United States, the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI) provides accurate counts of fatal work injuries based on confirmation of work relationship from multiple sources, while the National Highway Traffic Safety Administration (NHTSA) Fatality Analysis Reporting System (FARS) provides detailed data on fatal MVTCs based on police reports. Characterization of fatal work-related MVTCs is currently limited by data sources that lack either data on potential risk factors (CFOI) or work-relatedness confirmation and employment characteristics (FARS). BLS and the National Institute for Occupational Safety and Health (NIOSH) collaborated to analyze a merged data file created by BLS using CFOI and FARS data. A matching algorithm was created to link 2010 data from CFOI and FARS using date of incident and other case characteristics, allowing for flexibility in variables to address coding discrepancies. Using the matching algorithm, 953 of the 1044 CFOI "Highway" cases (91%) for 2010 were successfully linked to FARS. Further analysis revealed systematic differences between cases identified as work-related by both systems and by CFOI alone. Among cases identified as work-related by CFOI alone, the fatally-injured worker was considerably more likely to have been employed outside the transportation and warehousing industry or transportation-related occupations, and to have been the occupant of a vehicle other than a heavy truck. This study is the first step of a collaboration between BLS, NHTSA, and NIOSH to improve the completeness and quality of data on fatal work-related MVTCs. It has demonstrated the feasibility and value of matching data on fatal work-related traffic crashes from CFOI and FARS. The results will lead to improvements in CFOI and FARS case capture, while also providing researchers with a better description of fatal work-related MVTCs than would be available from the two data sources separately.
Export Promotion of OFDI from Emerging Markets – Transaction-level Evidence from China

Outward foreign direct investment (OFDI) from emerging markets has been increasing rapidly. A common perception is that this type of OFDI was driven by the countries’ resource and technology seekin...
Antibiotic Resistance and Enterococcal Infections among Inpatients with Lower Respiratory Infection

OBJECTIVE To investigate the prevalence of enterococcal infection and the susceptibility of Enterococcus to antibacterial agents in hospitalized patients of our hospital. METHODS Retrospective study of the clinical materials of 101 cases with lower respiratory tract infection caused by Enterococcus in hospital,bacterial susceptibility was analyzed. RESULTS A total of 101 Enterococcus strains were isolated from sputum,14 cases from respiratory ward and 19 cases from RICU. Ages, prolonged hospitalization,severe underlying diseases,invasive operation and application of multiple antibiotics might be the risk factors of Enterococcus infection. Ampicillin and penicillin were susceptible against E. faecalis ,inhibition rates being 83.3% and 77.8%,respectively. Strains of E.faecium were more resistant than that of E. faecalis . Vancomycin was the most active agent against enterococcal isolates. In 101 isolated strains 81 were high level aminoglycoside-resistant (HLAR). CONCLUSIONS The prevalence of enterococcal infection in lower respiratory tract is increased. Vancomycin has the best antibacterial activity against Enterococcus . Early diagnosis and rational treatment are the key to cure these patients.
Impact of an In-Class Biochemistry Mini-Conference on Students' Perception of Science.

The work presented here is the summary of a 3 year study that aimed to uncover how students’ perception of science changes with the chance to participate in a mini-conference that is incorporated into the biochemistry lecture course. Students were asked to work in groups of 2 or 3 and research a topic that is related to the material covered in class. Their research was presented during the last lecture of the course, and the presentation was conducted similar to a conference poster session. The students’ grades on this assignment were entirely based on peer evaluation and not on evaluation by the instructor. A survey was conducted before and after this assignment to gauge how the experience changed students’ perception of science. The study was conducted with both STEM majors and non-STEM majors to allow comparison of how these two groups of students were affected by the experience.
Day of Surgery Affects Length of Stay and Charges in Primary Total Hip and Knee Arthroplasty

Abstract Background Length of hospital stay (LOS) is a large driver of cost after primary total joint arthroplasty (TJA). Strategies to decrease LOS may help reduce the economic burden of TJA. This study's aim was to investigate the effect of day of the week of surgery on mean LOS and total charges following primary total knee arthroplasty (TKA) and total hip arthroplasty (THA). Methods An administrative clinical database at a large US health care system was reviewed for all primary THA and TKA admissions performed between 2010 and 2012 (n = 15,237). Of these, 14,800 cases met our inclusion criteria and were analyzed. Furthermore, the cohort was divided into early (Monday/Tuesday) and late week (Thursday/Friday) surgeries, excluding Wednesday surgeries (n = 2835). Univariate and multiple regression analyses examined the effect of each variable on LOS. Results Mean LOS for THA and TKA on Monday was 3.54 and 3.35 days and increased to 4.12 and 3.66 days on Friday ( P P P = .02) and severity of illness score (0.781 days per level increase, P P Conclusion Late week TJA cases, older age, and increasing severity of illness score were associated with increased LOS. Furthermore, late week TKA was associated with increased total charges.
The Bible Gentry

‘You who know the precise line in which I walk at Cambridge’, wrote the famous evangelical the Revd Charles Simeon from Dublin in 1822, ‘would be astonished as I myself was, to find earls and viscounts, deans and dignitaries, judges, etc. calling on me … I dined at the Countess of Westmeath’s and met Judge Daly and many other characters of the highest respectability’.1 There was a certain irony in Simeon’s response to this display of religious enthusiasm among the upper ranks of Dublin society. The purpose of his visit was to attend the April meetings of the evangelical societies and to support their cause, since growing criticism of their influence had recently caused several bishops of the Church of Ireland to resign as patrons of both the British and Foreign Bible Society (BFBS) and its Irish counterpart the Hibernian Bible Society (HBS).2 The Bible Society controversy of 1821 was a symptom of the extraordinary growth of the evangelical movement throughout the British Isles during the first two decades of the nineteenth century. Concern over the Independent tendencies of Bible Society supporters had caused leading theologians of the Church of England to condemn the policy of distributing the Bible without note or comment ‘thus encouraging the notion that men might draw their own religion from it’.3 In light of such censure from church authorities, it is not surprising that Simeon should express gratification at the evidence that the cause of serious religion was showing no sign of losing its momentum in Dublin.
Temperature Dependent Thermal Conductivity and Thermal Interface Resistance of Pentacene Thin Films with Varying Morphology.

Temperature dependent thermal conductivities and thermal interface resistances of pentacene (Pn) thin films deposited on silicon substrates and self-assembled monolayer-modified [octadecyltrichlorosilane (OTS) and (3-aminopropyl)triethoxysilane (APTES)] silicon substrates were measured using frequency domain thermoreflectance. Atomic force microscopy images were used to derive an effective film thickness for thermal transport that accounts for surface roughness. Data taken over a temperature range of 77–300 K for various morphologies and film thicknesses show that the thermal conductivity increases with increasing Pn grain size. The sum of the substrate-Pn and Pn-gold thermal interface resistances was isolated from the intrinsic thermal resistance of the Pn films and found to be independent of surface chemistry. Corresponding Kapitza lengths of approximately 150 nm are larger than the physical thicknesses of typical Pn thin films and indicate that the interfaces play a dominant role in the total thermal r...
Arginine Diet for Sickle Transgenic Mice Reduces Endothelin-1-Stimulated Gardos Channel Activity.

Abstract Arginine (ARG) supplementation (5% arginine in chow) restores plasma ARG levels in S+S-Antilles mice to that found in C57BL mice and is associated with a reduction in Ca++ activated K+ channel (Gardos channel) activity, MCHC and high density red cells (Romero, Blood 99(4):2002). However the mechanisms for these effects are not entirely clear. Endothelin-1 (ET) is a potent vasoconstrictor that has been shown to activate Gardos channel activity and reduce MCHC. We hypothesized that reduced ET could account for the decrease in Gardos channel activity. We report here that arginine diet reduced ET levels in mouse plasma from 137 ± 10 to 89 ± 17 pmol/ml using a modified HPLC technique originally proposed by Kumarathasan (Anal Biochem 299:37, 2001). We measured Gardos channel activity in ex vivo red cells as the influx of 86Rb in the presence or absence 10μM clotrimazole. Consistent with our previous report, we observed that ARG supplementation was associated with a decrease in Gardos Channel activity. In addition, incubation of red cells with 500 nmol/L of ET for 15 min at 37°C stimulated an increase in Gardos channel activity in cells from both ARG supplemented vs non-supplemented mice that was sensitive to 1 mmol/L of the specific ET receptor B antagonist, BQ788 (9.4 ± 2.5 vs 14.6 ± 3.8 mmol/L cell x h, respectively). However, the maximal response of the Gardos channel activity to ET was significantly blunted in ARG supplemented vs non-supplemented mice (15.7 ± 2.8 vs 22.1 ± 2.2 mmol/L cell x h, p
BASELINE STRAIN: A POSSIBLE PREDICTOR OF ISCHEMIA ON STRESS ECHOCARDIOGRAPHY

Several studies have shown that LV strain can predict LV dysfunction prior to a reduction in ejection fraction on echocardiogram as well as detect ischemia at peak stress and during angioplasty. Given its potential for characterizing ischemia we chose to evaluate baseline strain as a predictive
Clinical and developmental perspectives on adolescent coping.

Although the development of appropriate coping strategies has been understood as an essential element of healthy adjustment, few studies have demonstrated the link between coping and psychological development. Similarly, research on adolescents with behavioral problems has neglected coping as an important variable in understanding and treating these conditions. This study examines the relationships between psychological development, coping strategies and symptoms in a sample of 302 psychiatrically hospitalized adolescents, ages 12–16. Subjects completed the Adolescent Coping Orientation for Problem Strategies Questionnaire, (A-COPE), the Youth Self Report symptom checklist (YSR), and Loevinger's measure of ego development. Results showed that Avoidance and Ventilation were associated with increased behavior problems and lower levels of ego development. Problem solving and interpersonal strategies were associated with fewer symptoms and higher levels of development. Significant gender differences were found with girls using more interpersonal coping and boys using more physically active strategies. Gender differences were also found in the relationship of coping strategies to both symptomatic behavior and development. The results are discussed in the context of a developmental approach to adolescent psychopathology.
The Thrombolysis in Myocardial Infarction (TIMI) Trial

Thrombolytic therapy for acute myocardial infarction has been one of the major advances in cardiology occurring during the last decade and a half. The Thrombolysis in Myocardial Infarction (TIMI) trials are a series of studies begun in 1984, initially under the sponsorship of the National Heart Lung and Blood Institute. A list of TIMI trials is shown in Table 1. The TIMI 1 trial investigated the relative efficacy of intravenous streptokinase and tissue-type plasminogen activator (t-PA). The TIMI 2 trial examined three strategies for acute MI, focusing on the role of adjunctive angioplasty following thrombolytic therapy, either immediately, routinely or as clinically warranted by recurrent ischemia. The TIMI 3 trial explored the role of thrombolytic therapy across the spectrum of acute ischemic syndromes, focusing on unstable angina and non-Q wave MI, and on the role of an early invasive strategy. The TIMI 4 trial tested two new regimens of thrombolytic therapy, front-loaded t-PA and combination thrombolytic therapy, against standard therapy with a non-fibrin specific agent. The TIMI 5 and 6 trials were pilot trials comparing the new thrombin inhibitor hirudin to heparin given in conjunction with aspirin and t-PA or streptokinase respectively. The TIMI 7 trial was a dose ranging trial of the specific thrombin inhibitor hirulog, for patients with unstable angina. The TIMI 8 trial will be a large scale clinical trial comparing hirulog to heparin in patients with the acute ischemic syndromes of unstable angina and non-Q wave MI, and TIMI 9 will be a large scale clinical trial comparing hirudin to heparin in conjunction with thrombolytic therapy for acute myocardial infarction. This chapter will highlight the major findings of the trials with data available as of this writing.
Presenting History and Common Symptoms of Spine Tumors

Spinal tumors may cause a variety of symptoms depending on their type, location, and rate of growth. The symptomatology differs depending on tumor location (e.g., extradural or vertebral column vs intradural-extramedullary vs intramedullary). Vertebral column tumors are divided into primary and metastatic. Primary tumors include neoplasms of the marrow (e.g., multiple myeloma), and tumors of the bone or the cartilage of the spine (1). Metastatic spinal pathology is much more common than primary neoplastic pathology. The spine is the most common site of skeletal metastasis (2). A spinal metastasis is found in as many as 70 to 90% of patients dying of cancer (3,4). The most common tumors that metastasize to the spine are tumors of the lung, breast, prostate, kidney, lymphoma, melanoma, and gastrointestinal tract (5). In the pediatric population, spinal metastasis commonly arise from neuroblastoma, rhabdomyosarcoma, leukemia, and histiocytosis; less commonly from lymphoma, Wilms’ tumor, and primitive neuroectodermal tumor (6). Meningiomas and nerve sheath tumors (schwannomas and neurofibromas) comprise the overwhelming majority of the intradural-extramedullary tumors. Astrocytoma, ependymoma, and hemangioblastoma account for the majority of the intramedullary tumors.
The Body's Use of Energy

This chapter focuses on the body's use of energy. To understand this subject, one should have an idea about the metabolism of energy in man. Energy metabolism is the oxidation or combustion that is going on in the animal's body during life. The fundamental processes of nutrition take place in the cells. The cell is a structural unit with a boundary or cell membrane consisting of a double wall composed of several alternate layers of protein and lipid substances. The cell membrane determines the transfer of nutrients into the cell. The chapter also discusses how nutrients get inside the cells. A summary of the factors involved in body composition is essential to understand the body's need for energy. Different tissues have different energy levels with muscle mass constituting the major portion of energy expenditure of the body even under resting conditions. The chapter reviews the different facets of energy expenditure, and discusses basal metabolism as a portion of daily energy expenditure and total energy expenditures. Basal metabolism, expressed as kilocalories per unit of body size, shows a remarkable uniformity between individual persons of similar size and age ranges. The total energy expenditure of the body depends on its size and composition, and on the level and duration of activity. The energy cost of work depends on the number of muscles involved, the duration of the activity, the speed or rate of movement, and the total strength exerted. The chapter further analyzes concepts such as energy balance and weight control, and regulation of food intake.
Transvenous lead extraction during uninterrupted warfarin therapy: Feasibility and outcomes.

Background Uninterrupted anticoagulation is important for patients at high risk for thromboembolism. Bridging with heparin/enoxaparin increases the risk of hematoma and infection. There are no published data on the feasibility of transvenous lead extraction (TLE) during uninterrupted anticoagulation. Objective The purpose of this study was to examine the feasibility and safety of TLE during uninterrupted warfarin therapy with therapeutic international normalized ratio (INR). Methods We performed a retrospective study of patients undergoing TLE while receiving uninterrupted warfarin therapy with INR ≥2.0 at a high-volume center. Results Between March 2011 and December 2016, 1212 patients underwent TLE. Of these patients, 62 underwent TLE during uninterrupted warfarin therapy with therapeutic INR (mean 2.5 ± 0.5; range 2.0–4.5). The cohort was 85% male, mean age 65 years, CHA2DS2-VASc score 3.4 ± 1.6, and left ventricular ejection fraction 41% ± 16%. A total of 114 of 116 leads were completely removed. These include 45 (38.4%) defibrillator leads of average age 7.8 ± 3.7 years, 65 (55.6%) pace-sense leads of average age 10.5 ± 6.6 years, and 6 (5.2%) coronary sinus lead of average age 5.5 ± 3.4 years. There was a 98.4% procedural and clinical success rate. Two patients had procedure-related complications: 1 small pericardial effusion that resolved spontaneously, and 1 femoral vein tear due to extraction of a large mass of a disrupted implantable cardioverter–defibrillator lead requiring vascular repair. Conclusion TLE during uninterrupted warfarin therapy with therapeutic INR may be considered in patients at high risk for thromboembolism if performed by experienced operators at high-volume centers.
Case 4: 18-year-old Young Man with Chest Pressure, Shortness of Breath, Fatigue, and Hyponatremia.

1. Heather Finlay-Morreale, MD* 1. *Nashaway Pediatrics UMass Memorial Medical Group, Sterling, MA An 18-year-old male presents to the emergency department with a 3-day history of chest pressure and shortness of breath. He has a history of pectus excavatum surgery (4 years earlier), juvenile rheumatoid arthritis in remission, and trivial aortic root dilation. As a child he had slightly elevated thyrotropin levels and negative antibodies and briefly took levothyroxine. His heart rate is 91 to 96 beats/min, and his blood pressure (BP) is 100/67 to 110/69 mm Hg. Laboratory results include the following: sodium, 125 mEq/L (125 mmol/L); potassium, 5.4 mEq/L (5.4 mmol/L); chloride, 92 mEq/L (92 mmol/L); carbon dioxide, 24 mEq/L (24 mmol/L); anion gap, 9 mEq/L (9 mmol/L); glucose, 142 mg/dL (7.88 mmol/L); blood urea nitrogen, 33 mg/dL (11.8 mmol/L); creatinine, 0.97 mg/dL (85.75 μmol/L); glomerular filtration rate, greater than 60 mg/dL; troponin I, less than 0.01 ng/mL (<0.01 μg/L); brain-type natriuretic peptide, 6 pg/mL (6 ng/L) (reference range, <35 pg/mL [<35 ng/L]); and D-dimer, 0.31 μg/mL (1.70 nmol/L) (reference range, <0.5 μg/mL [<2.7 nmol/L]). His electrocardiogram is notable for incomplete right bundle branch block (unchanged from earlier) and ST elevation. Findings from chest radiography are normal. After serious cardiac and pulmonary events are ruled out, he is given a bolus of intravenous normal saline and discharged to follow-up with his primary care doctor who he had not seen for three years. …
Adult cardiac veno-arterial extracorporeal life support (VA-ECMO): prevention and management of acute complications

Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been shown to be a viable and effective treatment for patients suffering from refractory cardiogenic shock (rCS), which is associated with high mortality rates. Although ECMO therapy used as short-term mechanical circulatory support (MCS) has shown tremendous growth in its application over the past decade, the complication and mortality rates remain high. This retrospective study analyzes complications associated with VA-ECMO support, evaluates the use of defined protocols at a single center, and examines factors that may contribute to patient complication and mortalit Methods: This retrospective analysis included 184 patients who were supported with ECMO from September 2014 through March 2018 at Integris Baptist Medical Center (IBMC). Descriptive statistics were generated to analyze baseline characteristics, demographics, complications, and outcomes. Results: Acute myocardial infarct (AMI) was the primary etiology of this cohort (N=40; 22%). The mean age was 55±15 (median 56, range 15–84) years. All patients were inotrope and/or vasopressor dependent prior to ECMO initiation. Mean time on ECMO support was 7.8±7.9 days with median time of 6 days. Total patient days on support were 1,430. Most ECMO cannulations, 97 (52%) were performed within Integris Baptist Medical Center, with 48% done outside the hospital; 38% were performed outside of the hospital by the IBMC ECMO team, and 10.5% were performed by an outside team. Bleeding was noted to be the most common VA ECMO complication [N=41; 22.3%; 0.028 events per patient day (EPPD)]. Conclusions: A dedicated 24/7 ECMO service using a multidisciplinary team (MDT) and defined protocols in a single center is able to effectively reduce complications due to VA-ECMO support in the sickest of the sick VA-ECMO patients.
Parasitic Resistance Reduction Strategies for Advanced CMOS FinFETs Beyond 7nm

This work thoroughly investigates the external parasitic resistance in advanced FinFET technology. The optimization of the parasitic resistance is systematically examined in terms of 1) source/drain epi resistance, 2) contact resistance and 3) middle of line metal stud resistance. Various resistance reduction knobs have been experimentally explored in these three aspects and low contact resistivity of $1\times 10^{-9}$ and $7\times 10^{-10} \Omega\cdot \text{cm}^{2}$ have been demonstrated on transistor level for NFET and PFET. By combining all the parasitic resistance reduction strategies, more than 70% and 60% reductions [1] in external parasitic resistance have been realized on NFET and PFET, respectively.
Design and evaluation of a novel technology for ambulatory monitoring of bruxism events

Abstract Bruxism is a widespread phenomenon whose diagnosis is usually made from non reliable, self-evaluation of the patient on one hand, and clinical signs whose absence does not mean absence of bruxism on the other hand. Different methods have been used in research setting for the assessment of bruxism such as portable electromyography but currently there exists no reliable method for the diagnosis of bruxism at home. In this paper, the hardware and software architecture of a complete ambulatory system, enabling long term monitoring of bruxism by measuring clenching/grinding forces of the patient is presented. The results of the tests conducted in vitro to evaluate the sensor's response are also presented. In vivo tests exhibited good correlation with an electromyography of the masseter muscle. With a maximum thickness of 2 mm, the discomfort for the patient is reduced and corresponds nearly to the usual thickness of an occlusal splint. This inductively rechargeable instrumented splint enables a long-term use over different periods and clenching/grinding data can be retrieved locally or transmitted wirelessly via WiFi, on a secured server, for further analysis.
Single-Crystal CdTe Homojunction Structures for Solar Cell Applications

We report two different CdTe homojunction solar cell structures. Single-crystal CdTe homojunction solar cells were grown on GaAs single-crystal substrates by metalorganic chemical vapor deposition. Arsenic and iodine were used as dopants for p-type and n-type CdTe, respectively. Another homojunction solar cell structure was fabricated by growing n-type CdTe directly on bulk p-type CdTe single-crystal substrates. The electrical properties of the different layers were characterized by Hall measurements. When arsine was used as arsenic source, the highest hole concentration was ~6 × 1016 cm–3 and the activation efficiency was ~3%. Very abrupt arsenic doping profiles were observed by secondary ion mass spectrometry. For n-type CdTe with a growth temperature of 250°C and a high Cd/Te ratio the electron concentration was ~4.5 × 1016 cm–3. Because of the 300 nm thick n-type CdTe layer, the short circuit current of the solar cell grown on the bulk CdTe substrate was less than 10 mA/cm2. The open circuit voltage of the device was 0.86 V. According to a prediction based on measurement of short circuit current density (J sc) as a function of open circuit voltage (V oc), an open circuit voltage of 0.92 V could be achieved by growing CdTe solar cells on bulk CdTe substrates.
Amyotrophic Lateral Sclerosis and Motor Neuron Disorders

Amyotrophic lateral sclerosis (ALS) is a progressive, paralytic disease that affects both upper (brain) and lower (spine and brainstem) motor neurons. While classic ALS is thought to largely spare bladder, bowel, and sphincter function, symptoms can be heterogeneous and phenotypic variants along the motor neuron disease spectrum such as primary lateral sclerosis (PLS) may have more significant lower urinary tract symptoms. Urinary symptoms have been reported in up to 44% of those affected and urinary urgency was the most common symptom. Neurogenic detrusor over activity and detrusor sphincter dyssynergia are common and are associated to storage and voiding symptoms. The urologic care of patients with motor neuron disorders requires a thoughtful and comprehensive approach as these patients may have contraindications to traditional non-invasive medical therapy and may also have significant perioperative risk factors.
Assessment for the Common Core Mathematics Standards

This article makes two simple observations about high-stakes assessments. The first is that, because mathematics is a very technical subject, an assessment item can be mathematically flawed regardless of how elementary it is. For this reason, every assessment project needs the active participation of high level mathematicians. A second point is that high-stakes assessments are inherently a very blunt instrument because they are incapable of accurately measuring the most important aspect of mathematics achievement: sustained sequential thinking. Because the general public and policy makers are not aware of this fact, they tend to read more into such assessment scores than such a limited instrument can deliver. If we want high-stakes assessments to have a positive influence on mathematics education, this article suggests that we should reorient our thinking about how much student achievement such assessments can reliably measure, which is “not very much.”
Medical Comanagement of Hip Fracture Patients Is Not Associated with Superior Perioperative Outcomes: A Propensity Score-Matched Retrospective Cohort Analysis of the National Surgical Quality Improvement Project.

BACKGROUND Medical comanagement entails a significant commitment of clinical resources with the aim of improving perioperative outcomes for patients admitted with hip fractures. To our knowledge, no national analyses have demonstrated whether patients benefit from this practice. METHODS We performed a retrospective cohort analysis of the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) targeted user file for hip fracture 2016-2017. Medical comanagement is a dedicated variable in the NSQIP. Propensity score matching was performed to control for baseline differences associated with comanagement. Matched pairs binary logistic regression was then performed to determine the effect of comanagement on the following primary outcomes: mortality and a composite endpoint of major morbidity. RESULTS Unadjusted analyses demonstrated that patients receiving medical comanagement were older and sicker with a greater burden of comorbidities. Comanagement did not have a higher proportion of patients participating in a standardized hip fracture program (53.6% vs 53.7%; P > .05). Comanagement was associated with a higher unadjusted rate of mortality (6.9% vs 4.0%, odds ratio [OR] 1.79: 1.44-2.22; P < .0001) and morbidity (19.5% vs 9.6%, OR 2.28: 1.98-2.63; P < .0001). After propensity score matching was used to control for baseline differences associated with comanagement, patients in the comanagement cohort continued to demonstrate inferior mortality (OR 1.36: 1.02-1.81; P = .033) and morbidity (OR 1.82: 1.52-2.20; P < .0001). CONCLUSIONS This analysis does not provide evidence that dedicated medical comanagement of hip fracture patients is associated with superior perioperative outcomes. Further efforts may be needed to refine opportunities to modify the significant morbidity and mortality that persists in this population.
Use of a Standardized Dalbavancin Approach to Facilitate Earlier Hospital Discharge for Vulnerable Patients Receiving Prolonged Inpatient Antibiotic Therapy

Twenty-seven patients receiving prolonged inpatient antibiotic therapy for a serious bacterial infection received a single dose of dalbavancin 7-10 days before the planned end date to facilitate earlier hospital discharge. Eighty-one percent met criteria for clinical success, 7% experienced a potential adverse event, and 182 hospital days were averted.
An Algorithm for Constructing Monotone Quintic Interpolating Splines

A novel algorithm for computing monotone order six piecewise polynomial interpolants is proposed. Algebraic constraints for enforcing monotonicity are provided that align with quintic monotonicity theory. The algorithm is implemented, tested, and applied to several sample problems to demonstrate the improved accuracy of monotone quintic spline interpolants compared to the previous state-of-the-art monotone cubic spline interpolants.
Does Social Media Engagement Translate to Civic Engagement Offline

People increasingly engage in politics on social media, but does online engagement translate to offline engagement? Research is mixed with some suggesting how one uses the internet maters. We exami...
Understanding the roles of atomic layer deposition in improving the electrochemical performance of lithium-ion batteries

Rechargeable lithium-ion batteries have been widely used as energy storage devices in electric vehicles and other smart devices due to their excellent properties, such as high energy and power densities, long-term service life, and acceptable cost. The electrochemical performance of the materials in a lithium-ion battery system determines the performance of the battery, so it is essential that the electrochemical properties of these materials be improved. Atomic layer deposition is a versatile thin film coating technique for surface functionalization that can deposit a highly uniform thin film of nanoscale thickness on battery components, and it has been proven to improve the electrochemical performance of materials that operate in a lithium-ion battery system, such as rate capability, interface stability, and cycling life. This review paper focuses on recent advances of application of atomic layer deposition in lithium-ion batteries and summarizes the roles of such thin film coatings in improving the electrochemical performance of batteries. The present review summarizes and classifies the latest understanding of improvement mechanisms proposed by researchers according to different components in lithium-ion batteries, including cathodes, anodes, separators, and solid electrolytes. This review will not only help researchers in this field to comprehend the roles of atomic layer deposition thin film coating for improving the performance of various components in a battery system, but will also help them choose appropriate coating materials on battery components. In addition, we briefly discuss the limitations of atomic layer deposition in lithium-ion battery applications and the challenges that it faces in the future.
The Night Is Young: Sexuality in Mexico in the Time of AIDS

The Night Is Young: Sexuality in Mexico in the Time of AIDS. Hector Carrillo. Chicago: University of Chicago Press, 2002. 352 pp.
The international year of shelter for the homeless: Aims and national and international action

Abstract This article deals with the background of and the programme for the International Year of Shelter for the Homeless (1987). The author describes the Year as a practical effort to find affordable solutions to the growing shelter problem. A primary focus on national programmes and projects, plus emphasis in 1987 on policy development is intended to make the Year more than a mere event. Information on international, regional and national activities is used to illustrate how the programme is developing.
Gastroesophageal Reflux Disease

Gastroesophageal reflux (GER) is defined as a normal passage of gastric contents into the esophagus or oropharynx through a transient relaxation of lower esophageal sphincter. GER is a normal physiologic occurrence in children and occurs in two thirds of infants for the first year of life. Gastroesophageal reflux disease (GERD) consists of symptoms and complications secondary to persistent GER.
Review of Daniel Langton, The Apostle Paul in the Jewish Imagination: A Study in Modern Jewish-Christian Relations

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PeerClean: Unveiling peer-to-peer botnets through dynamic group behavior analysis

Advanced botnets adopt a peer-to-peer (P2P) infrastructure for more resilient command and control (C&C). Traditional detection techniques become less effective in identifying bots that communicate via a P2P structure. In this paper, we present PeerClean, a novel system that detects P2P botnets in real time using only high-level features extracted from C&C network flow traffic. PeerClean reliably distinguishes P2P bot-infected hosts from legitimate P2P hosts by jointly considering flow-level traffic statistics and network connection patterns. Instead of working on individual connections or hosts, PeerClean clusters hosts with similar flow traffic statistics into groups. It then extracts the collective and dynamic connection patterns of each group by leveraging a novel dynamic group behavior analysis. Comparing with the individual host-level connection patterns, the collective group patterns are more robust and differentiable. Multi-class classification models are then used to identify different types of bots based on the established patterns. To increase the detection probability, we further propose to train the model with average group behavior, but to explore the extreme group behavior for the detection. We evaluate PeerClean on real-world flow records from a campus network. Our evaluation shows that PeerClean is able to achieve high detection rates with few false positives.
Three-dimensional Fréchet sensitivity kernels for electromagnetic wave propagation

Electromagnetic imaging methods are useful tools for monitoring subsurface changes in pore-fluid content and the associated changes in electrical permittivity and conductivity. The most common method for georadar tomography uses a high frequency ray-theoretic approximation that is valid when material variations are sufficiently small relative to the wavelength of the propagating wave. Georadar methods, however, often utilize electromagnetic waves that propagate within heterogeneous media at frequencies where ray theory may not be applicable. In this paper we describe the 3-D Frechet sensitivity kernels for EM wave propagation. Various data functional types are formulated that consider all three components of the electric wavefield and incorporate near-, intermediate-, and far-field contributions. We show that EM waves exhibit substantial variations for different relative source-receiver component orientations. The 3-D sensitivities also illustrate out-of-plane effects that are not captured in 2-D sensitivity kernels and can influence results obtained using 2-D inversion methods to image structures that are in reality 3-D.