cssi/SciSciGPT-SciSciNet huggingface dataset:
Integrating Evidence-Based Practice into a Therapeutic Exercise Course: Real-Time Patient Experience

Athletic training students need real-time patient experiences in order to transfer the knowledge and skills learned in the classroom into clinical practice. The objective is to present a descriptio...
The secret health care system: guatemala 1988.

This article relates the response of the people of Guatemala and addresses those conditions in Guatemala that reflect the health needs of the people and the governments measures to meet and use these needs for political and military ends. The official health care system provided by the Guatemalan government has failed to give adequate health care especially in rural areas. The neonatal and postneonatal mortality rates per 100000 live births reflect the gravity of the situation. The Guatemalan mortality rates in 1978 were 3 to 10 times higher than the rates for Honduras Nicaragua and the US. 80% of health services are concentrated in Guatemala City leaving 65% of the population without services. 75% of the population has no potable water service and 82% of children under the age of 5 suffer from some form of malnutrition. Large portions of the population have been displaced by violence hunger and loss of agricultural work. The military has used the provisioning of health and medical care as a political weapon. In response to such harsh conditions the people have created a clandestine health care system based on the secret training of village health workers to treat medical and emotional problems and to teach basic public health procedures. Government opposition to this health system has included crushing peasant resistance with violence and shooting practicing health care workers as well as assigning physicians in support of the system to death lists. (Authors modified)
Reevaluation of the relaxed calcaneal stance position. Reliability and normal values in children and adults.

Reliability and normal values for the relaxed calcaneal stance position were determined in a nonclinic population of healthy adults and children (88 adults and 124 children) ranging in age from 5 to 36 years. The mean relaxed calcaneal stance position for adults was 6.07 degrees valgus (SD 2.71 degrees) (range, 1 degree varus to 14 degrees valgus). The mean relaxed calcaneal stance position for children was 5.6 degrees valgus (SD 2.9 degrees) (range, 6 degrees varus to 12 degrees valgus). There was no significant difference between the relaxed calcaneal stance positions of adults and children. In children the relaxed calcaneal stance position did not correlate with age, height, or weight and did not decrease with age to the theoretical normal value of 0 degree +/- 2 degrees as postulated by Root et al. The relaxed calcaneal stance position was found to be a reliable measurement; however, the theoretical normal value of 0 degree +/- 2 degrees was not found. The values reported in the present study correspo...
An open letter to public health nurses.

ABSTRACT Public health nursing celebrated its 100th anniversary in 1993. In a guest editorial for Public Health Nursing Dr. Marla Salmon, then director of the Division of Nursing, Bureau of Health Professions, U. S. Department of Health and Human Services, wrote a “retrospective vision” in which she projected the roles that American public health nurses would play in 21st century health care reform. The picture she painted was highly optimistic and 16 years later the profession has yet to realize the accomplishments Salmon envisioned: a more visible leadership in directing health policy, creation of systems that expand public health department roles in both direct and indirect services, cooperation among agencies, and empowerment of the communities and individuals served by the public health care system. As she saw it, the period between 1893 and 1993 was a prelude to the coming of age of public health nursing as a specialty. She cautioned that those who practice public health nursing between 1993 and 2093 are responsible for authoring the next volume of history through their own actions. This historical reprint originally appeared in the December 1993 issue of Public Health Nursing.
On the relationship between stratospheric aerosols and nitrogen dioxide

Observations of the stratospheric NO2 column amount over the Colorado mountains during January, February, and March, 1992 are compared to concurrent lidar measurements. During this period, large aerosol amounts due to the volcanic material injected into the stratosphere by Mt. Pinatubo were observed over Colorado. The observed NO2 column displays a strong anti-correlation with increasing amounts of stratospheric aerosol near 25–30 km for relatively low aerosol loadings. At higher aerosol loadings, the NO2 response appears to saturate, displaying little further reduction. The reasons for the altitude dependence of this relationship are probed with a one-dimensional stratospheric model, and it is shown that such a saturation response is to be expected for conditions where the heterogeneous reaction between N2O5 and H2O dominates the NOx chemistry, as in Prather [1992]. The results therefore provide evidence that heterogeneous reactions influence the chemical composition of the mid-latitude stratosphere, and in the general manner predicted by theory.
An alternative algorithm for high speed multiplication and addition using growing technique

An alternative algorithm is presented for multiplication/addition of variable bit-size operands. The algorithm is shown to be fast, and the computational time is variable and dependent on the accuracy requested. The growing nature of the product term, during the course of operation, gives the method some unique computational properties. The algorithm is implemented for the design of 32*32-bit multiplier. >
On the application of FACTS controllers derived from lossless models to lossy systems

This paper studies the effects of applying controls for FACTS (flexible AC transmission system) devices derived from energy functions for lossless systems to systems with losses. The intent is to examine whether such controls can be effective, and under what circumstances they could produce a destabilizing effect.
Social network-based botnet command-and-control: emerging threats and countermeasures

Botnets have become a major threat in cyberspace. In order to effectively combat botnets, we need to understand a botnet's Command-and-Control (C&C), which is challenging because C&C strategies and methods evolve rapidly. Very recently, botmasters have begun to exploit social network websites (e.g., Twitter.com) as their C&C infrastructures, which turns out to be quite stealthy because it is hard to distinguish the C&C activities from the normal social networking traffic. In this paper, we study the problem of using social networks as botnet C&C infrastructures. Treating as a starting point the current generation of social network-based botnet C&C, we envision the evolution of such C&C methods and explore social networks-based countermeasures.
Fault accommodation of a class of nonlinear dynamical systems using a learning approach

The paper presents a robust fault diagnosis scheme for detecting and accommodating faults occurring in a class of nonlinear multi-input multi-output dynamical systems. Changes in the system dynamics due to a fault are modeled as nonlinear functions of the control input and state variables. The fault function can model slowly developing (incipient) or abrupt faults, with each component of the fault vector being represented by a separate time profile. The stability of the robust fault accommodation scheme is established using Lyapunov redesign methods.
The choice of functional form and estimation of banking inefficiency

The effects of alternative functional forms on parametric estimation of a multi-product cost function are examined using a sample of rural US banks. Functional forms considered for possible choice are three versions of second-order Taylor-series expansions (or locally-flexible functional forms–translog, normalized quadratic, and generalized Leontief. The generalized quadratic Box–Cox transformation and the likelihood dominance criterion are used as vehicles for conducting nested and non-nested tests. Although all three forms are rejected by the nested test, the likelihood dominance criterion indicates that the translog is clearly preferred over the other two as the functional form of choice. Using either of the other functional forms would substantially alter conclusions about both scale elasticities and inefficiencies, including the impact of bank size on these measures.
Aminopyrine infusion breath test for the determination of changes in P450 metabolism in vivo

1. An osmotic mini-pump was used to maintain a constant infusion of radiolabelled [N-dimethyl-14C] aminopyrine into a rat. After implanting the mini-pump, 14CO2 expiration rate was constant within 12h, and this rate was maintained for 192 h.2. Treatment with 2-diethylaminoethyl-2,2-diphenylvalerate HCl (SKF 525-A) or cimetidine, inhibitors of P450-dependent metabolism, resulted in both dose- and time-dependent inhibition of the expiration of 14CO2.
Analysis of the Influence of Film-Forming Compounds on Droplet Growth: Implications for Cloud Microphysical Processes and Climate

Abstract Decades of cloud microphysical research have not provided conclusive understanding of the physical processes responsible for droplet spectral broadening. Numerous mechanisms have been proposed—for example, entrainment mixing, vortex shedding, giant cloud condensation nuclei (CCN), chemical processing of CCN, and radiative cooling—all of which are likely candidates under select conditions. In this paper it is suggested that variability in the composition of CCN, and in particular, the existence of condensation inhibiting compounds, is another possible candidate. The inferred potential abundance of these amphiphilic film-forming compounds (FFCs) suggests that their effect may be important. Using a cloud parcel model with a simplified treatment of the effect of FFCs, it is shown that modest concentrations of FFCs (on the order of 5% of the total aerosol mass) can have a marked effect on drop growth and can cause significant increases in spectral dispersions. Moreover, it is shown that FFCs may, in s...
RsbT and RsbV Contribute to σB-Dependent Survival under Environmental, Energy, and Intracellular Stress Conditions in Listeria monocytogenes

Sigma B (sigma(B)) is a stress-responsive alternative sigma factor that has been identified in various gram-positive bacteria. Seven different regulators of sigma B (Rsbs) are located in the sigB operons of both Bacillus subtilis and Listeria monocytogenes. In B. subtilis, these proteins contribute to regulation of sigma(B) activity by conveying environmental and energy stress signals through two well-established branches of a signal transduction pathway. RsbT contributes to regulation of sigma(B) activity in response to environmental stresses, while RsbV contributes to sigma(B) activation under both environmental and energy stresses in B. subtilis. To probe L. monocytogenes Rsb roles in sigma(B)-mediated responses to various stresses, in-frame deletions were created in rsbT and rsbV. Phenotypic characterization of the L. monocytogenes rsbT and rsbV null mutants revealed that both mutants were similar to the DeltasigB strain in their abilities to survive under environmental stress conditions (exposure to synthetic gastric fluid, pH 2.5, acidified brain heart infusion broth [BHI], or oxidative stress [13 mM cumene hydroperoxide]). Under energy stress conditions (carbon starvation in defined media, entry into stationary phase, or reduced intracellular ATP), both DeltarsbT and DeltarsbV showed survival reductions similar to that of the DeltasigB strain. These observations suggest that the pathways for Rsb-dependent regulation of sigma(B) activity differ between L. monocytogenes and B. subtilis. As sigma(B) also activates transcription of the L. monocytogenes prfAP2 promoter, we evaluated virulence-associated characteristics of DeltaprfAP1rsbT and DeltaprfAP1rsbV double mutants in hemolysis and tissue culture assays. Both double mutants showed identical phenotypes to DeltaprfAP1P2 and DeltaprfAP1sigB double mutants, i.e., reduced hemolysis activity and reduced plaque size in mouse fibroblast cells. These findings indicate that RsbT and RsbV both contribute to sigma(B) activation in L. monocytogenes during exposure to environmental and energy stresses as well as during tissue culture infection.
The Influence of a Change in Medicare Reimbursement on the Effectiveness of Stage III or Greater Decubitus Ulcer Home Health Nursing Care

This study was designed to describe and evaluate the influence of a change in a Medicare reimbursement on the effectiveness of home health nursing care for stage III or greater decubitus ulcer patients. This health policy originated from the Balanced Budget Act (BBA) of 1997 and took its full effect with initiation of the Prospective Payment System (PPS) on October 1, 2000. A quantitative quasi-experimental design used OASIS data from the state of Virginia to evaluate 555 stage III or greater decubitus ulcer patients, age 65 or older. Comparisons were investigated between pre-PPS, 2000, and post-PPS, 2001, outcomes related to reported ulcer healing, lengths of stay, and discharge disposition. Results demonstrated significant differences for the outcomes studied. In addition, sanitation, ulcer healing, and discharge disposition were linked as predictors for length of stay. Results demonstrated that PPS has affected nursing care effectiveness for stage III or greater decubitus ulcer home health patients.
Uncertainty and the Evolution of Cooperation

It is well known that inferential errors can induce nice but provocable strategies to engage in vendettas with each other. It is therefore generally believed that imperfect monitoring reduces the payoffs of such strategies and impairs the evolution of cooperation. The current literature, however, only scrutinizes specific strategies, either analytically or in particular tournaments. This article examines in a more general way how monitoring uncertainty affects the fate of cooperation in tournaments of the iterated prisoner's dilemma (IPD). The first set of results shows that imperfect monitoring does create a sharp trade-off between cooperativeness and unexploitability. The second set examines how random shocks affect the tournament payoffs of several large classes of strategies in the IPD, and shows how noise can help certain nice strategies. The third set analyzes how imperfect monitoring can facilitate the emergence of cooperation based on a population of non-nice strategies. Thus the idea that inferen...
Moore's law: the future of Si microelectronics

Soon after Bardeen, Brattain, and Shockley invented a solid-state device in 1947 1 to replace electron vacuum tubes, the microelectronics industry and a revolution started. Since its birth, the industry has experienced four decades of unprecedented explosive growth driven by two factors: Noyce and Kilby inventing the planar integrated circuit 2 , 3 and the advantageous characteristics that result from scaling (shrinking) solid-state devices.
Community Oncology Medical Homes: Physician-Driven Change to Improve Patient Care and Reduce Costs

The Community Oncology Medical Home offers a patient-centered model of care to improve quality and continuity of care.
Evaluation of painful hip arthroplasties. Are technetium bone scans necessary

We reviewed the plain radiographs, bone scans and hip aspiration results of 54 patients with painful hip arthroplasties which had been explored surgically, to compare the results of the investigations with the operative findings. For acetabular loosening, the sensitivity and specificity of bone scanning were 87% and 95%, with an accuracy of 90%: for serial plain radiography sensitivity was 95%, specificity 100% and accuracy 97%. For femoral component loosening, bone scan sensitivity was 85%, specificity 100% and accuracy 89%: the sensitivity of plain radiography was 100%, with specificity 92% and accuracy 98%. Technetium bone scanning did not provide additional information with regard to loosening and is not necessary in the routine investigation of a painful hip arthroplasty. Serial pain radiography is the most effective method of detecting loosening, and bone scanning is useful only when radiography is inconclusive with regard to loosening or infection.
In praise of strategies

This programmatic note high-lights a major theme in my lecture notes "Logic in Games"[37]: the need for explicit logics that define agents' strategies, as the drivers of interaction in games. Our text outlines issues, recalls recent results, and raises new open problems. Results are mainly quoted, and the emphasis is on new notions and questions. For more details on the various topics discussed, see the relevant references.
Living and training in moderate hypoxia does not improveV˙o 2 max more than living and training in normoxia

The objective of these experiments was to determine whether living and training in moderate hypoxia (MHx) confers an advantage on maximal normoxic exercise capacity compared with living and trainin...
Hypoxia paradoxically inhibits the angiogenic response of isolated vessel explants while inducing overexpression of vascular endothelial growth factor

This study was designed to investigate how changes in O2 levels affected angiogenesis in vascular organ culture. Although hypoxia is a potent inducer of angiogenesis, aortic rings cultured in collagen paradoxically failed to produce an angiogenic response in 1-4 % O2. Additionally, aortic neovessels preformed in atmospheric O2 lost pericytes and regressed at a faster rate than control when exposed to hypoxia. Aortic explants remained viable in hypoxia and produced an angiogenic response when returned to atmospheric O2. Hypoxic aortic rings were unresponsive to VEGF, while increased oxygenation of the system dose-dependently enhanced VEGF-induced angiogenesis. Hypoxia-induced refractoriness to angiogenic stimulation was not restricted to the aorta because similar results were obtained with vena cava explants or isolated endothelial cells. Unlike endothelial cells, aorta-derived mural cells were unaffected by hypoxia. Hypoxia downregulated expression in aortic explants of key signaling molecules including VEGFR2, NRP1 and Prkc-beta while upregulating expression of VEGFR1. Medium conditioned by hypoxic cultures exhibited angiostatic and anti-VEGF activities likely mediated by sVEGFr1. Hypoxia reduced expression of VEGFR1 and VEGFR2 in endothelial cells while upregulating VEGFR1 in macrophages and VEGF in both macrophages and mural cells. Thus, changes in O2 levels profoundly affect the endothelial response to angiogenic stimuli. These results suggest that hypoxia-induced angiogenesis is fine-tuned by complex regulatory mechanisms involving not only production of angiogenic factors including VEGF but also differential regulation of VEGFR expression in different cell types and production of inhibitors of VEGF function such as sVEGFR1.
Crystal structure of ortho­rhom­bic {bis­[(pyridin-2-yl)meth­yl](3,5,5,5-tetra­chloro­pent­yl)amine-κ3N,N′,N′′}chlorido­copper(II) perchlorate

In the title compound, [CuCl(C17H19Cl4N3)]ClO4, the CuII ion adopts a distorted square-planar geometry defined by one chloride ligand and the three nitro­gen atoms from the bis­[(pyridin-2-yl)meth­yl](3,5,5,5-tetra­chloro­pent­yl)amine ligand. The perchlorate counter-ion is disordered over three sets of sites with refined occupancies 0.0634 (17), 0.221 (16) and 0.145 (7). In addition, the hetero-scorpionate arm of the bis­[(pyridin-2-yl)meth­yl](3,5,5,5-tetra­chloro­pent­yl)amine ligand is disordered over two sets of sites with refined occupancies 0.839 (2) and 0.161 (2). In the crystal, weak Cu⋯Cl inter­actions between symmetry-related mol­ecules create a dimerization with a chloride occupying the apical position of the square-pyramidal geometry typical of many copper(II) chloride hetero-scorpionate complexes.
Interview with Carla G. Perna, BS, CCRP

For this issue, we share the career highlights of Carla G. Perna, BS, CCRP, who, while advancing from research assistant to program director, has dedicated her clinical research career to oncology research. Q: How did you first become interested in clinical research, and can you describe the path
Fluorescent Pigments for Marking Lesser Grain Borers (Coleoptera: Bostrichidae)

Fluorescent dyed melamine copolymer resins were evaluated to determine their effectiveness for marking adult Rhyzopertha dominica to be used in release-recapture experiments. Pigments were retained very well, and marked individuals were easily identified under longwave ultraviolet light up to 21 d after treatment. Little pigment was transferred between individuals during mating or other contact within a bulk of wheat. Treatment with fluorescent pigment did not reduce fecundity or prevent flight activity.
STUDY ON A NEW EVALUATION METHOD FOR OIL SOLUBLE INHtB1TORS

Taking naphthenic acid and vacuum 2nd side cut as corrosion medium,a new static weight loss method of oil soluble inhibitor was examined in order to evaluate the performance of oil soluble inhibitors used in refineries.With adding a certain amount of alcohol into the evaluating medium to increase the dissolving capacity of inhibitor,electrochemical evaluation method of oil soluble inhibitor was set up.Process inhibitor used in refinery was tested and effect of test conditions as well as time effect was discussed.
Probabilistic segmentation of time-series audio signals using Support Vector Machines

To allow health tracking, patient monitoring, and provide timely user interventions, sensor signals from body sensor networks need to be processed in real-time. Time subdivisions of the sensor signals are extracted and fed into a supervised learning algorithm, such as Support Vector Machines (SVM), to learn a model capable of distinguishing different class labels. However, selecting a short-duration window from the continuous data stream is a significant challenge, and the window may not be properly centered around the activity of interest. In this work, we address the issue of window selection from a continuous data stream, using an optimized SVM-based probability model. To evaluate the effectiveness of our approach, we apply our algorithm to audio signals acquired from a wearable nutrition-monitoring necklace. Our optimized algorithm is capable of correctly classifying 86.1% of instances, compared to a baseline of 73% which segments the time-series data with fixed-size non-overlapping windows, and an exhaustive-search approach with an accuracy of 92.6%.11This work is funded by the National Science Foundation AIR Option 1: Award Number 1312310.
Snoring predicts hyperactivity four years later.

Study objectives Cross-sectional studies implicate snoring and sleep-disordered breathing as potential contributors to hyperactive behavior in some children. However, no prospective cohort study has demonstrated that symptoms of sleep-disordered breathing precede development of hyperactivity. Participants Parents of 229 children aged 2 to 13 years, recruited at 2 general pediatrics clinics, completed initial and 4-year follow-up surveys. Measurements Surveys included a validated Pediatric Sleep Questionnaire about snoring, sleepiness, and overall risk of sleep-disordered breathing, and the hyperactivity index (expressed as a T-score) within the Conners' Parent Rating Scale. Results Thirty children (13%) were rated as hyperactive (hyperactivity index > 60) at follow-up. After adjustment for hyperactivity at baseline and stimulant use at follow-up, hyperactivity at follow-up was predicted by baseline habitual snoring (odds ratio = 4.4, 95% confidence interval [1.3, 14.7]) or loud snoring (4.5, [1.2, 17.5]) and by top-quartile composite scores for snoring (5.3, [1.7, 16.8]), sleepiness (3.0, [1.0, 9.4]), or sleep-disordered breathing (4.0, [1.4, 11.6]). Conclusions This 4-year prospective cohort study shows that snoring and other symptoms of sleep-disordered breathing are strong risk factors for future emergence or exacerbation of hyperactive behavior. These findings support the hypothesis that untreated childhood sleep-disordered breathing contributes to development of hyperactivity.
National Institutes of Health Update: Translating Basic Behavioral Science into New Pediatric Obesity Interventions

Pediatric obesity increases the risk of later-life obesity and chronic diseases. Basic research to better understand factors associated with excessive weight gain in early life and studies translating research findings into preventive and therapeutic strategies are essential to our ability to better prevent and treat childhood obesity. This overview describes several National Institutes of Health efforts designed to stimulate basic and translational research in childhood obesity prevention and treatment. These examples demonstrate the value of research in early phase translational pediatric obesity research and highlight some promising directions for this important area of research.
The Business Case for Corporate Social Responsibility: A Critique and an Indirect Path Forward

Do firms benefit from their voluntary efforts to alleviate the many problems confronting society? A vast literature establishing a “business case” for corporate social responsibility (CSR) appears ...
Patient daily treatment verification using MLC log files

Purpose To investigate the viability of patient specific IMRT QA method which uses MLC log files to recreate a delivered fluence and compare to the planned fluence. Materials and methods A Varian Novalis Tx equipped with a HD120 MLC was used in this study. A total of 40 patients of both VMAT and step and shoot of various sites were used. Error containing plans were generated for 5 of the 40 patients. The errors introduced were MLC shifts, gantry angle errors and collimator errors. The treatment plans were delivered in air and the MLC log files recorded. An in-house MatLab program was used to recreate the planned fluence from the dicomRT file for reference and recreate the delivered fluence using data from the MLC log files. The resulting beam fluence maps and composite fluence maps were then compared using the gamma index. Gamma passing percentages were then compared to the results of the original IMRT QA (performed using the Delta 4 to establish a correlation and compare error detection capabilities. Results The overall mean gamma values for the Delta 4 and the fluence comparisons were similar. Gamma passing percentages for the Delta 4 were 96.9% while the fluence comparisons resulted in averages of 99.7% and 98.8% for 3%/3 mm and 2%/2 mm respectively. The error detection capabilities of the fluence comparison method was on par with that of the Delta 4 . Conclusion Using fluences created from MLC log files for patient specific IMRT QA is a valid alternative to traditional methods. The ease of use and efficiency of the fluence method makes it an attractive option for routine patient specific IMRT QA.
Laboratory experiments on rain-driven convection: Implications for planetary dynamos

Abstract Compositional convection driven by precipitating solids or immiscible liquids has been invoked as a dynamo mechanism in planets and satellites throughout the solar system, including Mercury, Ganymede, and the Earth. Here we report laboratory experiments on turbulent rain-driven convection, analogs for the flows generated by precipitation within planetary fluid interiors. We subject a two-layer fluid to a uniform intensity rainfall, in which the rain is immiscible in the upper layer and miscible in the lower layer. Rain falls through the upper layer and accumulates as a two-fluid emulsion in the interfacial region between the layers. In experiments where the rain is denser than the lower fluid, rain-injected vortices evolve into small-scale plumes that rapidly coalesce into larger structures, resulting in turbulent convection throughout the lower layer. The turbulent convective velocity in our experiments increases approximately as the cube root of the rain buoyancy flux, implying little or no dependence on viscous and chemical diffusivities. Applying diffusion-free scaling laws for magnetic field generation, we find that precipitation-driven convection can be an effective dynamo mechanism in planetary cores provided the precipitation buoyancy flux is large and the convecting region is deep and nearly adiabatic.
Future directions in chimeric antigen receptor T cell therapy

Purpose of reviewThe impact of immunotherapy has grown exponentially in the past 5 years. Principle illustrations are encouraging results with engineered T cells expressing a chimeric antigen receptor (CAR). This experimental therapy is developing simultaneously in pediatric and adult clinical trial
Initial clinical outcomes of audiovisual-assisted therapeutic ambience in radiation therapy (AVATAR)

Abstract Purpose Radiation therapy is an important component of treatment for many childhood cancers. Depending upon the age and maturity of the child, pediatric radiation therapy often requires general anesthesia for immobilization, position reproducibility, and daily treatment delivery. We designed and clinically implemented a radiation therapy–compatible audiovisual system that allows children to watch streaming video during treatment, with the goal of reducing the need for daily anesthesia through immersion in video. Methods and materials We designed an audiovisual-assisted therapeutic ambience in radiation therapy (AVATAR) system using a digital media player with wireless streaming and pico projector, and a radiolucent display screen positioned within the child's field of view to him or her with sufficient entertainment and distraction for the duration of serial treatments without the need for daily anesthesia. We piloted this system in 25 pediatric patients between the ages of 3 and 12 years. We calculated the number of fractions of radiation for which this system was used successfully and anesthesia avoided and compared it with the anesthesia rates reported in the literature for children of this age. Results Twenty-three of 25 patients (92%) were able to complete the prescribed course of radiation therapy without anesthesia using the AVATAR system, with a total of 441 fractions of treatment administered when using AVATAR. The median age of patients successfully treated with this approach was 6 years. Seven of the 23 patients were initially treated with daily anesthesia and were successfully transitioned to use of the AVATAR system. Patients and families reported an improved treatment experience with the use of the AVATAR system compared with anesthesia. Conclusions The AVATAR system enables a high proportion of children to undergo radiation therapy without anesthesia compared with reported anesthesia rates, justifying continued development and clinical investigation of this technique.
Islet Microencapsulation: Strategies and Clinical Status in Diabetes

Type 1 diabetes mellitus (T1DM) is an autoimmune disease that results from the destruction of insulin-producing pancreatic β cells in the islets of Langerhans. Islet cell transplantation has become a successful therapy for specific patients with T1DM with hypoglycemic unawareness. The reversal of T1DM by islet transplantation is now performed at many major medical facilities throughout the world. However, many challenges must still be overcome in order to achieve continuous, long-term successful transplant outcomes. Two major obstacles to this therapy are a lack of islet cells for transplantation and the need for life-long immunosuppressive treatment. Microencapsulation is seen as a technology that can overcome both these limitations of islet cell transplantation. This review depicts the present state of microencapsulated islet transplantation. Microencapsulation can play a significant role in overcoming the need for immunosuppression and lack of donor islet cells. This review focuses on microencapsulation and the clinical status of the technology in combating T1DM.
Religious perspectives on assisted suicide.

Yale Kamisar's writings add up to an impressive argument against the legalization of assisted suicide and euthanasia, an achievement all the more notable because it does not depend on a blanket moral condemnation of these practices and so avoids becoming mired in the contemporary debate over moral pluralism. My assigned task, nonetheless, is to explore the contribution of religious thought to the debates over both the morality of physician-assisted suicide (PAS) /euthanasia and the moral implications of their legalization. I have chosen to end with feminist theological and philosophical reflections on these questions because they supplement in important ways the "official" positions of religious bodies and so illuminate the assisted suicide debate freshly. The whole cant of this discussion may reveal a medieval sensibility about the connections between law and morality: that the bindingness of law depends on its justice, and its justice is dependent on its genuinely advancing the common good.' But given our current understandings of the ways in which social practices construct morality, perhaps such medievalism is again appropriate. My reflections come in three parts. First, what do the religions say about PAS/euthanasia? Second, in what ways are those teachings relevant to courts and legislative bodies? And, finally, what can feminist philosophers and theologians contribute to the discourse?
Care of the Postablation Patient: Surveillance, Acid Suppression, and Treatment of Recurrence.

Endoscopic eradication therapy is effective and durable for the treatment of Barrett's esophagus (BE), with low rates of recurrence of dysplasia but significant rates of recurrence of intestinal metaplasia. Identified risk factors for recurrence include age and length of BE before treatment and may also include presence of a large hiatal hernia, higher grade of dysplasia before treatment, and history of smoking. Current guidelines for surveillance following ablation are limited, with recommendations based on low-quality evidence and expert opinion. New modalities including optical coherence tomography and wide-area tissue sampling with computer-assisted analysis show promise as adjunctive surveillance modalities.
Feeding wet distillers grains plus solubles contributes to sarcoplasmic reticulum membrane instability

Feeding wet distillers grains plus solubles (WDGS) increases polyunsaturated fatty acid (PUFA) levels in beef. It was hypothesised that WDGS in feedlot diets increases PUFA concentration in the sarcoplasmic reticulum (SR) membrane, thereby altering membrane integrity, resulting in more rapid intracellular calcium leakage and improved tenderness. The objective of this study was to evaluate this hypothesis. Ninety-six crossbred steers were fed either a corn-based diet with 0% WDGS or 50% WDGS. Fifteen strip loins per treatment were collected, fabricated into steaks, aged and placed under retail display conditions. Steaks were used to measure tenderness, proteolysis, free calcium concentrations, lipid oxidation, sarcomere length and SR membrane fatty acid, phospholipid lipid, neutral lipid and total lipid profiles. Compared with steaks from steers fed 0% WDGS, steaks from steers fed 50% WDGS were more tender (P 0.10) in sarcomere length or proteolysis. This study showed that feeding WDGS may increase tenderness, possibly by increasing free calcium in muscle early post-mortem. However, the true mechanism that contributes to these differences is still unclear.
Diabetes and Tooth Loss among Working-Age African Americans: A National Perspective.

Natural teeth are still lost in adults despite improvements in dental care and access to treatment across the life span. The study examined whether tooth loss can be mitigated in adults experiencing diabetes. National online survey data from the Service Utilization among African Americans with Co-morbid Depression and Diabetes (n = 275) were analyzed using logistic regression analyses. Diabetes was most prevalent among men (73.5%) and least prevalent among women (40.6%). In general and among the women, those without diabetes have approximately 50% fewer missing teeth than those with diabetes (odds ratio = .50; 95% confidence interval: 0.30, 0.83). Tooth loss is a traumatic experience and a serious life event that requires professional attention.
Evaluating the BANCS Streambank Erosion Framework on the Northern Gulf of Mexico Coastal Plain

The Bank Assessment of Nonpoint source Consequences of Sediment (BANCS) framework allows river scientists to predict annual sediment yield from eroding streambanks within a hydrophysiographic region. BANCS involves field data collection and the calibration of an empirical model incorporating a bank erodibility hazard index (BEHI) and near-bank shear stress (NBS) estimate. Here we evaluate the applicability of BANCS to the northern Gulf of Mexico coastal plain, a region that has not been previously studied in this context. Erosion rates averaged over two years expressed the highest variability of any existing BANCS study. As a result, four standard BANCS models did not yield statistically significant correlations to measured erosion rates. Modifications to two widely used NBS estimates improved their correlations (r2 = 0.31 and r2 = 0.33), but further grouping of the data by BEHI weakened these correlations. The high variability in measured erosion rates is partly due to the regional hydrologic and climatic characteristics of the Gulf coastal plains, which include large, infrequent precipitation events. Other sources of variability include variations in bank vegetation and the complex hydro- and morphodynamics of meandering, sand bed channels. We discuss directions for future research in developing a streambank erosion model for this and similar regions.
Breaking the cycle of opioid use disorder with Ibogaine.

Ibogaine is an indole alkaloid that comes from the root of the West African shrub Tabernanthe iboga. Ibogaine has been used for centuries in spiritual celebrations, coming of age rituals, and heali...
Fashioning Identity: Status Ambivalence in Contemporary Fashion

Understanding, interpreting, and theorizing fashion change has long fascinated scholars in the fields of sociology, anthropology, history, fashion, and dress studies, among others. Maria Mackinney-...
Time to Entry for New Cancer Medicines: From European Union-Wide Marketing Authorization to Patient Access in Belgium, Estonia, Scotland, and Sweden.

Abstract Objectives First, to quantify the median time from European Union (EU)-wide approval to first use (launch) for a sample of cancer medicines and number of launches in Belgium, Estonia, Scotland, and Sweden as of June 2015. Second, to assess whether longer times to launch or lack of launches affected medicines with high or low expected additional clinical benefit. Third, to identify possible determinants of the probability of a cancer medicine to be launched. Methods Correlation between time to launch and a set of variables hypothesized to affect launch was tested using a complementary log-log model for a sample of 46 cancer medicines that obtained EU-wide marketing authorization between 2000 and 2014. Results In median, for a sample of 24 cancer medicines that obtained marketing authorization between 2010 and 2014, the expected time from EU-wide marketing authorization to first use of a medicine was shortest in Sweden, 3.1 months, followed by Scotland (9.3 months), Belgium (14.8 months), and Estonia (27.8 months). Median times to launch were longer for the entire sample of 46 cancer medicines that obtained marketing authorization between 2000 and 2014. In the all-country model, medicines with shorter times to submission for reimbursement, local manufacturers headquarter (or local sales representative), and a Food and Drugs Administration priority review or a combination of expedited approval programs and medicines launched in Scotland and Sweden were associated with a higher hazard of launch. Longer times since EU-wide approval initially correlate with an increased hazard but as time further elapses they negatively affect the hazard of launch. Conclusions Median times from marketing authorization to first use of cancer medicines were shorter for medicines launched between 2010 and 2014 versus sample-wide (2000–2014). In Estonia, more medicines than in the other countries were not yet launched at the end of the observation period. There was no correlation between Prescrire and European School of Medical Oncology Magnitude of Clinical Benefit Scale ratings of added clinical value and time to launch.
Total pancreaticoduodenectomy with autologous islet transplantation 14 years after liver-contained composite visceral transplantation.

Chronic pancreatitis (CP) is a severely disabling disorder with potential detrimental effects on quality of life, gut function, and glucose homeostasis. Disease progression often results in irreversible morphological and functional abnormalities with development of chronic pain, mechanical obstruction, and pancreatic insufficiency. Along with comprehensive medical management, the concept of total pancreatectomy and islet autotransplantation (TP-AIT) was introduced 40 years ago for patients with intractable pain and preserved beta-cell function. With anticipated technical difficulties, total excision of the inflamed-disfigured gland is expected to alleviate the incapacitating visceral pain and correct other associated abdominal pathology. With retrieval of sufficient islet-cell mass, the autologous transplant procedure has the potential to maintain an euglycemic state without exogenous insulin requirement. The reported herein case of CP-induced recalcitrant pain and foregut obstruction is exceptional because of the technical challenges in performing native pancreaticoduodenectomy in close proximity to the composite visceral allograft with complex vascular and gut reconstructions. Equally novel is transplanting the auto-islets in the liver-contained visceral allograft. Despite intravenous nutrition shortly after birth, liver transplantation at age 13, retransplantation with liver-contained visceral allograft at age 17 and TP-AIT at age 31, the 38-year-old recipient is currently pain free with full nutritional autonomy and normal glucose homeostasis.
Modeling Crew Itineraries and Delays in the National Air Transportation System

We propose, optimize, and validate a methodological framework for estimating the extent of the crew-propagated delays and disruptions (CPDDs). We identify the factors that influence the extent of the CPDDs and incorporate them into a robust crew-scheduling model. We develop a fast heuristic approach for solving the inverse of this robust crew-scheduling problem to generate crew schedules that are similar to real-world crew-scheduling samples. We develop a sequence of exact and heuristic techniques to quickly solve the forward problem within a small optimality gap for network sizes that are among the largest in robust crew-scheduling literature. Computational results using four large real-world airline networks demonstrate that the crew schedules produced by our approach generate propagation patterns similar to those observed in the real world. Extensive out-of-sample validation tests indicate that the parameters calibrated for one network perform reasonably well for other networks. We provide new insights...
Psychoeducational Problems that Present as Academic Difficulties

Psychoeducational problems frequently result in academic difficulties. Using a thorough procedure for the assessment of psychoeducational problems, including an understanding of the conceptual basis for the assessment; referral procedures; planning that must take place to gain quality information from the assessment procedure; and understanding the types of assessment techniques and procedures that will yield appropriate and helpful information precede the identification of disability. These activities provide the groundwork for making decisions as to the psychoeducational problem that may be related to the academic difficulties, and provide the basis for making educational intervention decisions.
Linking Services Design to Strategy

Services Design can be a key asset for competitive advantage, as an instrument for operational excellence or strategic positioning. As the activity aimed to create meaning, design plays a pervasive role on strategic positioning. From the need to develop the design discourse according to the strategic position and vice-versa. This paper focuses on the conceptual connections between both, defining a framework for their simultaneous development and definition, in straight connection to the company’s activities. We present and describe the use of a specific methodology tool, the Strategic Design Opportunity Matrix (SDOM), that allows a visual description of the areas of design on which to perform, according to selected value attributes linked related to the company’s activities. This will contribute to the definition of the Design Discourse that will support the strategic positioning statement.
Game Design Workshop: A Playcentric Approach to Creating Innovative Games, Fourth Edition

This book helps you to create the digital games you love to play, using a non-technical approach to game design without the need for programming or artistic experience. Award-winning author Tracy Fullerton demystifies the creative process with clear and accessible guidance on the formal and dramatic systems of game design. Using examples of popular games, illustrations of design techniques, and refined exercises to strengthen your understanding of how game systems function, the book gives you the skills and tools necessary to create a compelling and engaging game. This fully updated 4th edition includes expanded coverage of new platforms and genres of play, including casual games and games for learning. It expands on agile development processes and includes a host of new perspectives from top industry game designers. Game Design Workshop puts you to work prototyping, playtesting, and revising your own games with time-tested methods and tools. These skills will provide the foundation for your career in any facet of the game industry including design, producing, programming, and visual design.
Identification of HPV molecular triggers in cutaneous squamous cell carcinoma.

e20084 Background: Cutaneous squamous cell carcinoma (SCC) a malignant tumor derived from epidermal keratinocytes and occurs predominately in sun-exposed skin. Organ transplant recipients have 60-2...
Multiple Boundary Layer Instability Modes with Nonequilibrium and Wall Temperature Effects Using LASTRAC

Prediction and control of boundary layer transition from laminar to turbulent is important to many flow regimes and vehicle designs, including vehicles operating at hypersonic conditions where nonequilibrium effects may be encountered. Wall cooling is known to affect the instability characteristics of the boundary layer and subsequently the transition location. Design considerations, including material failure and fuel chemistry, require the use of actively cooled walls in hypersonic vehicles, further motivating the study of wall temperature effects on top of the considerations of reducing heat flux, drag, and uncertainty. In this work, we analyze the stability of a boundary layer with chemical and thermal nonequilibrium on a Mach 20, 6 wedge. We investigate the effects of wall temperature on multiple unstable modes individually and on the integrated growth of disturbances along the surface. We use the LAngley Stability and TRansition Analysis Code (LASTRAC) to evaluate boundary layer stability, using capabilities implemented by the authors. Included are results that address chemical nonequilibrium with both thermal equilibrium and nonequilibrium.