cssi/SciSciGPT-SciSciNet huggingface dataset:
Superior vena cava-pulmonary artery anastomosis

Superior vena cava-right pulmonary artery anastomosis has been used to palliate cyanotic congenital heart disease in 42 patients with the following anomalies: tricuspid atresia, 19 cases; transposition of the great vessels, 11; pulmonary atresia, 6; truncus arteriosus, 3; Epstein’s malformation, 2; and atrioventricular canal with pulmonary stenosis, 1 case. Twelve of 13 operative deaths occurred in the 24 infants younger than 6 months of age. Five of 6 infants less than 1 month old died after the operation. Six late deaths were distributed among all age groups and all cardiac lesions. Although survivors were improved clinically, there is a gradual progression of cyanosis and rise of the hemoglobin level. It is clear that cava-pulmonary anastomosis should not be done in the first month of life. An ascending aorta-right pulmonary artery shunt is preferable, even in the first 6 months if the pulmonary artery is small. The cava-pulmonary anastomosis enlarges as the child grows, but increasing venous collateral may reduce its effectiveness. When complemented with a systemic-pulmonary shunt it has the potential for long-term palliation of uncorrectable congenital lesions.
In Vitro Expanded NK Cells Have Increased Natural Cytotoxity Receptors, TRAIL and NKG2D Expression, and Superior Tumor Cytotoxicity Compared to Short-Term IL-2 –Activated NK Cells.

Abstract Abstract 463 IL-2 activates NK cell enhancing their capacity to lyse tumor cells. To date, most clinical studies of adoptive NK cell transfer have utilized short-term (12-16 hours) IL-2-activated NK cells. Because IL-2 alone is ineffective in expanding NK cells in vitro, the relatively low numbers of NK cells obtained for infusion following short term IL-2 activation may limit the full therapeutic impact of this approach. To obtain larger numbers of NK cells, novel ex vivo expansion protocols that utilize irradiated EBV-LCL or K562 feeder cells have recently been developed. However, concerns exist that extensive ex vivo expansion might significantly reduce the in vivo proliferative potential and long-term viability of adoptively transferred NK cells. Here we investigated for differences in phenotype, tumor cytotoxicity and in vivo persistence between short-term IL-2 activated and long-term expanded NK cells. CD56+/CD3- NK cells were isolated from normal donors by immuno-magnetic bead selection and were either activated with IL-2 (500U/ml) for 12-16 hours or were expanded in vitro over 14 days using irradiated EBV-LCL feeder cells in IL-2 containing media (500U/ml). Short-term IL-2 activated NK cells did not expand in number in contrast to EBV-LCL stimulated NK cells which expanded 400-1000 fold by culture day 14. Flow cytometry analysis revealed no differences in expression of DNAM-1, 2B4, LFA-1 or granzyme B between short-term activated and expanded NK cells. However, expanded NK cells had significantly higher expression of TRAIL, NKG2D, and the natural cytotoxicity receptors NKp30, NKp44 and NKp46 and a slight increase in KIR3DL1 and KIR2DL2/3. A 4-hour 51Cr-release assay showed expanded NK cells were significantly more cytotoxic against K562 cell compared to short-term IL-2 activated NK cells; at a 1:1 effector to target ratio, 67±6%, 26±1%, and 9±1% of K562 cells were killed by expanded, short term IL-2 activated and fresh NK cells respectively (p In conclusion, these results demonstrate that ex vivo expanded NK cells are phenotypically and functionally different than short-term IL-2 activated NK cells. Expanded NK cells have increased expression of natural cytotoxicity receptors, NKG2D and TRAIL and have greater TRAIL-mediated tumor cytotoxicity compared to IL-2 activated NK cells. Importantly, despite extensive ex vivo proliferation, expanded NK cells appear maintain similar longevity in vivo as non-expanded short term IL-2 activated NK cells. Disclosures: No relevant conflicts of interest to declare.
Comparison of the efficacy of small and large‐bore thoracostomy tubes for pleural space evacuation in canine cadavers

Objective To determine if there is a difference in the amounts of air (A), low-viscosity fluid (LV), or high-viscosity fluid (HV) that can be aspirated from the pleural cavity of canine cadavers using small-bore (SB) or large-bore (LB) thoracostomy tubes. Design Prospective experimental ex vivo study. Setting University teaching hospital. Animals Thirty-six canine cadavers. Interventions Each cadaver was randomly assigned to 1 of 6 groups (SB-A, LB-A, SB-LV, LB-LV, SB-HV, LB-HV). In each cadaver bilateral thoracostomy tubes (either SB or LB) were placed and 20 mL/kg of air, LV fluid, or HV fluid was instilled via 1 thoracostomy tube. Both tubes were aspirated and the volume aspirated was recorded and analyzed as a percentage of instilled air or fluid volume. The procedure was repeated on the contralateral hemithorax. Measurements and Main Results There was no significant difference in air or fluid recovery when SB and LB groups were compared. Median (range) air recovery volumes in the SB-A and LB-A groups were 101.5% (94.4–115.8%) and 102.8% (94.1–107.8%), respectively (P = 0.898). Recovery of LV fluid was 93.5% (79.2–99.0%) for SB-LV and 85.8% (77.1–101.8%) for LB-LV cadavers (P = 0.305) and recovery percentages of HV fluid were 92.6% (86.1–96.2%) and 91.4% (74.2–96.4%) for SB-HV and LB-HV groups, respectively (P > 0.999). There was no significant difference between SB and LB groups when all substances were combined (94.1% [79.2–115.8%] and 93.5% [74.2–107.8%], respectively, P = 0.557). Conclusions SB and LB thoracostomy tubes demonstrated similar efficacy in removing known amounts of air, LV fluid, and HV fluid from the pleural space of canine cadavers. Further study is necessary to determine if SB and LB thoracostomy tubes demonstrate similar efficacy in clinical veterinary patients.
Validating Performance from the Perspective of End Users

Effective daylighting requires rethinking the simplified approach to glazing and facade systems to acknowledge the needs and behaviors of building occupants as a critical determinant of long-term performance. Occupants represent a rich multi-sensory source of information on environmental performance. This chapter argues that a lack of human factors data from buildings in use leads to environmental design that is largely detached from the preferences or needs of building occupants, with cascading implications for occupant comfort and energy use. Emerging methods for collecting human factors data on Indoor Environmental Quality (IEQ) are presented and discussed for integrating detailed occupant-feedback into building evaluation, operation, and the design process. This chapter concludes by proposing an approach to environmental design informed by examination of occupant behavior, personal modifications, and subjective assessments of IEQ and speculates on how this approach may lead to better outcomes for building occupants.
Predictors of illicit drug use among a national sample of adolescents

Background: Rates of illicit drug use are increasing among adolescents. This study was guided by Jessor’s problem behavior theory and explored the conceptual domains of risk factors for adolescent ...
Brief Announcement: Proust: A Design Space for Highly-Concurrent Transactional Data Structures

Most STM systems are poorly equipped to support libraries of concurrent data structures. One reason is that they typically detect conflicts by tracking transactions' read sets and write sets, an approach that often leads to false conflicts. A second is that existing data structures and libraries often need to be rewritten from scratch to support transactional conflict detection and rollback. This brief announcement introduces Proust, a framework for the design and implementation of transactional data structures. Proust is designed to maximize reuse of existing well-engineered libraries by providing transactional "wrappers" to make existing thread-safe concurrent data structures transactional. Proustian objects are also integrated with an underlying STM system, allowing them to take advantage of well-engineered STM conflict detection mechanisms. Proust generalizes and unifies prior approaches such as boosting and predication.
Analysis of Cell-Free DNA to Assess Risk of Tumoremia Following Endoscopic Ultrasound Fine-Needle Aspiration of Pancreatic Adenocarcinomas.

Background & Aims Cellular and nuclear material from tumors disseminates into the bloodstream (tumoremia), but it is not clear whether medical procedures cause release of this material or contribute to formation of metastases. We performed a prospective study of blood samples from patients with pancreatic adenocarcinoma (PDAC) to determine whether endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) associates with markers of tumoremia. Methods We obtained peripheral blood from 104 patients (35 with PDAC) before and after EUS-FNA of primary tumors; blood samples from 69 healthy individuals were used as controls. Plasma concentrations of cell-free DNA (cfDNA) were measured, and cfDNA and primary tumor samples were analyzed to detect activating mutations in KRAS. Potential development of tumoremia was defined by an increase in cfDNA of 2-fold or more, and/or detection of mutant KRAS in samples collected after FNA from patients whose blood samples did not contain detectable mutant KRAS before FNA. Results Peripheral blood concentrations of cfDNA were 1200 ng/ml (500–3300 ng/ml) before FNA vs 1400 ng/ml (900–4000 ng/ml) after FNA (P = .391). Tumoremia was detected in 10/35 patients (28.6%): 7 patients had a ≥2-fold increase in cfDNA concentration (20.6%) and 3 patients had circulating tumor DNA with KRAS mutations after FNA that were not detected before FNA (8.8%). New distant metastases were detected in 1.3 ± 0.82 patients with tumoremia vs 0.64 ± 0.81 without (P = .0375). Overall mortality did not differ significantly between patients with tumoremia (10/10 deaths, 100%) vs those without (19/25 deaths, 76%) nor did survival times of deceased patients (13.3 months for patients with tumoremia; range, 5.8–14.9 months vs 11.1 months for patients without tumoremia; range, 5.5–14.5 months). However, 6 patients without tumoremia were alive at a mean 23.9 months after EUS-FNA (range, 19.9–25 months after EUS-FNA) vs none of the patients with tumoremia. Conclusion In patients with PDAC, EUS-FNA associates with increased plasma concentration of cfDNA and increased detection of mutant KRAS after the procedure (markers of tumoremia and possible new distant metastasis). Although levels of cfDNA and activating mutations in KRAS are logical markers of tumoremia, they may not serve as the ideal biomarkers of this process. These findings are preliminary and do not indicate a need to modify current practice, yet further studies are needed.
The Use of Topical Steroids in Psoriasis

Topical steroids play an important role in treatment of psoriasis. Because of the possibility of a rebound phenomenon when they are discontinued, as well as the potential development of topical side effects and suppression of the pituitary-adrenal axis, they should be used judiciously. They can play an important role as an adjunct to other forms of therapy, such as when they are used in conjunction with tar preparations and ultraviolet light.
Participation of pigment epithelium of iris and ciliary body in ocular immune privilege. 1. Inhibition of T-cell activation in vitro by direct cell-to-cell contact

RESULTS. Cultured mouse I/CB PE cells (including CD95L-deficient cells), which were more than 95% keratin positive, suppressed T-cell proliferation and secretion of IFN-g, IL-2, IL-4, and IL-10 in a dose-dependent fashion in all three Tcr ligand systems. Supernatants of cultured I/CB PE cells displayed little suppression activity, whereas cultures in which I/CB PE cells contacted responding T cells directly were profoundly immunosuppressive. Cultured I/CB PE cells expressed mRNA for TGF-b1, TGF-b2, IL-6, IL-10, and TNF-a, but not IL-4, IFN-g, proopiomelanocortin (POMC), and CD95L (Fas L). Antibodies to TGF-b, IL-10, and TNF-a failed to reverse suppression mediated by I/CB PE cells. Moreover, neither exogenous IL-2 or IL-12 relieved the suppression. CONCLUSIONS. Cultured I/CB PE cells, through direct cell-to-cell contact, prevent T cells from proliferating and secreting cytokines when stimulated through the Tcr for antigen by a mechanism that does not involve CD95 or apoptosis. (Invest Ophthalmol Vis Sci. 2000;41:811‐ 821)
Interdiffusion of Gases in Porous Media

Many industrial processes involve interdiffusion of gases. Gas separation by selective diffusion through porous media and membranes is based on the selective permeability of these media to different molecular species. Moreover, gas diffusion to and from reaction sites in porous catalysts, porous fuel-cell electrodes or other condensed phases is sometimes the rate-controlling step in mass-transfer processes.
The Frequency of Monoclonal Gammopathy of Unknown Significance in Black and Caucasian Veterans in a Hospital Population

In the United States, for unknown reasons multiple myeloma occurs more frequently in Blacks than Caucasians (Blattner, 1980). To determine whether there is a similar increase of benign paraproteinemia or monoclonal gammopathy of unknown significance (MGUS) (Kyle, 1982) in Blacks, we initiated a screening program at the Washington DC Veterans Affairs Medical Center (Schechter et al, 1986). This study has been extended to include 2721 patients.
Traumatic Brain Injury in Sports

Few physicians realize the detriment and prevalence of head injury in the athlete. Due to the development of organized athletics with more standardized rules, which help to decide how head injury should be managed and when players should return to play, and due to the development of newer and better protective equipment, fatal and near-fatal head injuries have been declining. Still, mild traumatic brain injury or concussion is under-recognized and continues to have a significant impact on the future well-being of the athlete. Given the tremendous popularity of sports in the United States and the world, there are large numbers of athletes—competitive and recreational—who sustain mild traumatic brain injury. In 1997, The Centers for Disease Control and Prevention had already proclaimed that concussions had reached epidemic proportions in the United States. Further, there is accumulating evidence that mild traumatic brain injury, including sports-related concussion, may be more common and more devastating than previously considered. Traumatic brain injury (TBI) in sports is relatively uncommon occurrence that may be associated with significant morbidity and occasional mortality. Although TBI in sports is infrequent, certain contact/collision and high velocity sports have an increased risk of TBI (Table 2.1). There are several brain injury syndromes that can be encountered in sports. These include acute traumatic brain injury (ATBI), the second impact syndrome (SIS) and chronic traumatic brain injury (CTBI). ATBI represents the immediate effects of traumatic forces involving the brain, whereas CTBI represents the more long-term cumulative effects of traumatic forces to the brain. The SIS is a syndrome in which an athlete who sustains a second TBI while still symptomatic from an initial concussion and experiences malignant cerebral edema and herniation. These three categories of TBI are discussed in detail.
Impaired meningeal lymphatic vessel development worsens stroke outcome.

The discovery of meningeal lymphatic vessels (LVs) has sparked interest in identifying their role in diseases of the central nervous system. Similar to peripheral LVs, meningeal LVs depend on vascular endothelial growth factor receptor-3 (VEGFR3) signaling for development. Here we characterize the effect of stroke on meningeal LVs, and the impact of meningeal lymphatic hypoplasia on post-stroke outcomes. We show that photothrombosis (PT), but not transient middle cerebral artery occlusion (tMCAo), induces meningeal lymphangiogenesis in young male C57Bl/J6 mice. We also show that Vegfr3wt/mut mice develop significantly fewer meningeal LVs than Vegfr3wt/wt mice. Again, meningeal lymphangiogenesis occurs in the alymphatic zone lateral to the sagittal sinus only after PT-induced stroke in Vegfr3wt/wt mice. Interestingly, Vegfr3wt/mut mice develop larger stroke volumes than Vegfr3wt/wt mice after tMCAo, but not after PT. Our results reveal differences between PT and tMCAo models of stroke and underscore the need to consider method of stroke induction when investigating the role of meningeal lymphatics. Taken together, our data indicate that ischemic injury can induce the growth of meningeal LVs and that the absence of these LVs can impact post-stroke outcomes.
‘I Want to Wear It’: Fashioning Black Feminism in Mahogany (1975)

In this article I focus on the portrayal of fashionable clothing in the 1975 film Mahogany and connect it to the history of African American women engaging with sartorial self-representation as a m...
Abstract ES7-2: Practical approach to the axilla after neoadjuvant chemotherapy: What the clinical trials don't address

Neoadjuvant chemotherapy (NAC) was initially used in patients with inoperable breast cancer to improve resectability, but it is also beneficial in women with operable breast cancer, particularly with respect to the axilla. Nodal pathologic complete response (pCR) rates among clinically node-positive patients treated with modern systemic therapy range from 35-49%. The ability to downstage the axilla and potentially avoid axillary lymph node dissection (ALND) is one of the greatest surgical advantages of NAC. The optimal approach to the axilla after NAC varies based on the clinical nodal stage prior to NAC. In clinically node-negative patients, the use of sentinel lymph node biopsy (SLNB) after NAC has been well studied, with high identification rates and false-negative rates that are similar to the upfront surgery setting. In addition, regional recurrence rates are no different between clinically node-negative patients treated with SLNB alone after NAC, or those treated with upfront SLNB. In clinically node-positive patients, 3 single-arm prospective trials have demonstrated that SLNB after NAC results in a false-negative rate As all patients in the prospective trials had an ALND, the frequency with which ALND could be avoided with the use of NAC in clinically node-positive patients was not addressed, although more recent data have demonstrated that approximately 50% will achieve a nodal pCR and avoid ALND. Indications for ALND after NAC include any positive SLN (including micrometastases and isolated tumor cells), failed mapping, or patients presenting with inoperable breast cancer. Nodal recurrence rates among clinically node-positive patients treated with SLNB alone after NAC are largely unknown, with only one small study demonstrating low regional recurrence rates. Ultimately, the optimal treatment strategy to avoid ALND in patients with operable breast cancer is complex and based on a combination of tumor subtype, clinical nodal status, and type of breast surgery performed. With the continued use of modern systemic therapy and improved radiation techniques for breast cancer, our ability to de-escalate surgical care and reduce the morbidity of surgery, while still maintaining excellent disease control, has become our new standard of care. Citation Format: Barrio A. Practical approach to the axilla after neoadjuvant chemotherapy: What the clinical trials don9t address [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr ES7-2.
An in vitro and in vivo comparison of cartilage growth in chondrocyte-laden matrix metalloproteinase-sensitive poly(ethylene glycol) hydrogels with localized transforming growth factor β3.

Abstract While matrix-assisted autologous chondrocyte implantation has emerged as a promising therapy to treat focal chondral defects, matrices that support regeneration of hyaline cartilage remain challenging. The goal of this work was to investigate the potential of a matrix metalloproteinase (MMP)-sensitive poly(ethylene glycol) (PEG) hydrogel containing the tethered growth factor, transforming growth factor β3 (TGF-β3), and compare cartilage regeneration in vitro and in vivo. The in vitro environment comprised chemically-defined medium while the in vivo environment utilized the subcutaneous implant model in athymic mice. Porcine chondrocytes were isolated and expanded in 2D culture for 10 days prior to encapsulation. The presence of tethered TGF-β3 reduced cell spreading. Chondrocyte-laden hydrogels were analyzed for total sulfated glycosaminoglycan and collagen contents, MMP activity, and spatial deposition of aggrecan, decorin, biglycan, and collagens type II and I. The total amount of extracellular matrix (ECM) deposited in the hydrogel constructs was similar in vitro and in vivo. However, the in vitro environment was not able to support long-term culture up to 64 days of the engineered cartilage leading to the eventual breakdown of aggrecan. The in vivo environment, on the other hand, led to more elaborate ECM, which correlated with higher MMP activity, and an overall higher quality of engineered tissue that was rich in aggrecan, decorin, biglycan and collagen type II with minimal collagen type I. Overall, the MMP-sensitive PEG hydrogel containing tethered TGF-β3 is a promising matrix for hyaline cartilage regeneration in vivo. Statement of Significance Regenerating hyaline cartilage remains a significant clinical challenge. The resultant repair tissue is often fibrocartilage, which long-term cannot be sustained. The goal of this study was to investigate the potential of a synthetic hydrogel matrix containing peptide crosslinks that can be degraded by enzymes secreted by encapsulated cartilage cells (i.e., chondrocytes) and tethered growth factors, specifically TGF-β3, to provide localized chondrogenic cues to the cells. This hydrogel led to hyaline cartilage-like tissue growth in vitro and in vivo, with minimal formation of fibrocartilage. However, the tissue formed in vitro, could not be maintained long-term. In vivo this hydrogel shows great promise as a potential matrix for use in regenerating hyaline cartilage.
Preexposure Prophylaxis for the Prevention of HIV Infection: US Preventive Services Task Force Recommendation Statement

Importance An estimated 1.1 million individuals in the United States are currently living with HIV, and more than 700 000 persons have died of AIDS since the first cases were reported in 1981. In 2017, there were 38 281 new diagnoses of HIV infection reported in the United States; 81% of these new diagnoses were among males and 19% were among females. Although treatable, HIV infection has no cure and has significant health consequences. Objective To issue a new US Preventive Services Task Force (USPSTF) recommendation on preexposure prophylaxis (PrEP) for the prevention of HIV infection. Evidence Review The USPSTF reviewed the evidence on the benefits of PrEP for the prevention of HIV infection with oral tenofovir disoproxil fumarate monotherapy or combined tenofovir disoproxil fumarate and emtricitabine and whether the benefits vary by risk group, population subgroup, or regimen or dosing strategy; the diagnostic accuracy of risk assessment tools to identify persons at high risk of HIV acquisition; the rates of adherence to PrEP in primary care settings; the association between adherence and effectiveness of PrEP; and the harms of PrEP when used for HIV prevention. Findings The USPSTF found convincing evidence that PrEP is of substantial benefit in decreasing the risk of HIV infection in persons at high risk of HIV acquisition. The USPSTF also found convincing evidence that adherence to PrEP is highly associated with its efficacy in preventing the acquisition of HIV infection; thus, adherence to PrEP is central to realizing its benefit. The USPSTF found adequate evidence that PrEP is associated with small harms, including kidney and gastrointestinal adverse effects. The USPSTF concludes with high certainty that the magnitude of benefit of PrEP with oral tenofovir disoproxil fumarate–based therapy to reduce the risk of acquisition of HIV infection in persons at high risk is substantial. Conclusions and Recommendation The USPSTF recommends offering PrEP with effective antiretroviral therapy to persons at high risk of HIV acquisition. (A recommendation)
Bounds and Capacity Theorems for Cognitive Interference Channels With State

A class of cognitive interference channels with state are investigated, in which a primary transmitter sends a message to two receivers (receivers 1 and 2) with assistance of a cognitive transmitter (that knows the primary transmitter’s message), and the cognitive transmitter also sends a separate message to receiver 2. The channel is corrupted by an independent and identically distributed (i.i.d.) state sequence. The scenario, in which the state sequence is noncausally known at both the cognitive transmitter and receiver 2, is first studied. The capacity region is obtained for both the discrete memoryless and Gaussian channels. The second scenario, in which the state sequence is noncausally known only at the cognitive transmitter, is further studied. Inner and outer bounds on the capacity region are obtained for the discrete memoryless channel and its degraded version. The capacity region is characterized for the degraded semideterministic channel and for channels that satisfy a less noisy condition. The Gaussian channels are further studied, which are partitioned into two cases based on how the interference compares with the signal at receiver 1. For each case, inner and outer bounds on the capacity region are derived, and partial boundaries of the capacity region are characterized. The full capacity region is also characterized for channels that satisfy certain conditions. It is shown that certain Gaussian channels achieve the capacity of the same channels with state noncausally known at both the cognitive transmitter and receiver 2.
Physicians' gender and their use of electronic health records: findings from a mixed-methods usability study.

OBJECTIVE Physician burnout associated with EHRs is a major concern in health care. A comprehensive assessment of differences among physicians in the areas of EHR performance, efficiency, and satisfaction has not been conducted. The study sought to study relationships among physicians' performance, efficiency, perceived workload, satisfaction, and usability in using the electronic health record (EHR) with comparisons by age, gender, professional role, and years of experience with the EHR. MATERIALS AND METHODS Mixed-methods assessments of the medical intensivists' EHR use and perceptions. Using simulated cases, we employed standardized scales, performance measures, and extensive interviews. NASA Task Load Index (TLX), System Usability Scale (SUS), and Questionnaire on User Interface Satisfaction surveys were deployed. RESULTS The study enrolled 25 intensive care unit (ICU) physicians (11 residents, 9 fellows, 5 attendings); 12 (48%) were men, with a mean age of 33 (range, 28-55) years and a mean of 4 (interquartile range, 2.0-5.5) years of Epic experience. Overall task performance scores were similar for men (90% ± 9.3%) and women (92% ± 4.4%), with no statistically significant differences (P = .374). However, female physicians demonstrated higher efficiency in completion time (difference = 7.1 minutes; P = .207) and mouse clicks (difference = 54; P = .13). Overall, men reported significantly higher perceived EHR workload stress compared with women (difference = 17.5; P < .001). Men reported significantly higher levels of frustration with the EHR compared with women (difference = 33.15; P < .001). Women reported significantly higher satisfaction with the ease of use of the EHR interface than men (difference = 0.66; P =.03). The women's perceived overall usability of the EHR is marginally higher than that of the men (difference = 10.31; P =.06). CONCLUSIONS Among ICU physicians, we measured significant gender-based differences in perceived EHR workload stress, satisfaction, and usability-corresponding to objective patterns in EHR efficiency. Understanding the reasons for these differences may help reduce burnout and guide improvements to physician performance, efficiency, and satisfaction with EHR use. DESIGN Mixed-methods assessments of the medical intensivists' EHR use and perceptions. Using simulated cases, we employed standardized scales, performance measures, and extensive interviews.
Recovery from impaired working memory performance during chronic Δ-9-tetrahydrocannabinol administration to adolescent rhesus monkeys:

Background:The relationship between adolescent cannabis use and susceptibility to persistent cognitive impairments is poorly understood.Aims:We examined the effects of repeated exposure to Δ-9-tetr...
Mommy Groups as Sites for Deliberation in Everyday Speech

This study advances our knowledge of the role of metaphor in deliberation in everyday speech (with an emphasis on the role of competition, cooperation, and connection metaphors), which up to now has not been studied as an important discursive strategy in deliberation. Furthermore, the study contributes to our understanding of the discursive practices that happen during deliberation, as opposed to measuring, for example, deliberation’s effects. After all, scholars, more and more, are writing about deliberative communication as a means to understand how communities can improve the quality of their communication and decision-making to work through problems. Language strategies, such as metaphor, help deliberators resolve what scholars have referred to as “wicked problems” or problems that are negotiated across time and are latent with competing values and social identities. One example of a citizen-led, localized context, where community members work to address a “wicked problem” is the Salem Kids Group. In this paper, we argue that in the Salem Kids Group’s online and face-to-face discussions, three dominant family metaphors, competition, cooperation, and connection, work to structure and define parameters for the group’s everyday talk and hold important implications for everyday speech in deliberation.
Minimally Invasive Resection of Intracerebral Amyloidoma: Case Report and Systematic Review of the Literature.

Background Management of cerebral amyloidomas has lacked consensus owing to their rarity. We present a case and review 39 reported cases of amyloidomas in the literature, comparing their initial presentation, imaging characteristics, treatment, and progression. Case Description A 56-year-old woman presented with a history of intractable headaches and progressive speech difficulty. Imaging demonstrated a 1.7 × 2.6 cm left frontal subcortical hemorrhagic mass with an associated developmental venous anomaly, characteristics initially suggestive of a cavernous malformation. Diffusion tractography imaging was employed to avoid interference with the intact arcuate fasciculus and corticospinal tracts to minimize neurologic deficits. Conclusions To our knowledge, this is the first documented case of the use of diffusion tractography in preoperative planning for cerebral amyloidoma resection. Our systematic review of 39 reported cases of amyloidomas in the literature provided insight regarding how these rare lesions have manifested and progressed and further understanding of current theories regarding their etiology and pathophysiology. Cerebral amyloidomas are rare, localized, proteinaceous aggregates with variable presentation and prognosis and no apparent relationship to systemic amyloidosis. Biopsy may be useful in determination of progression. Diffusion tractography is a valuable tool for minimizing complications associated with resection.
Low-head, roughing filters for enhancing recycle water treatment for aquaculture

Carbon dioxide toxicity problems are being encountered in aquaculture systems in which oxygen injection is used to increase fish production in recirculating systems. Fish excretion, low water exchange and lack of air-water contact for stripping are responsible for the accumulation of carbon dioxide in a recirculating aquaculture system. The equilibrium relationships and rate processes related to carbon dioxide removal are discussed in this paper. The mechanisms for air-stripping carbon dioxide are discussed and equations based on steadystate mass balances are developed. The importance of proper ventilation of carbon dioxide from aquaculture systems within buildings is demonstrated. In addition, chemical treatment for carbon dioxide neutralization is discussed.
Stochastic home energy management system via approximate dynamic programming

This study proposes an approximate dynamic programming (ADP) method for a stochastic home energy management system (HEMS) that aims to minimise the electricity cost and discomfort of a household under uncertainties. The study focuses on a HEMS that optimally schedules heating, ventilation, and air conditioning, water heater, and electric vehicle, while accounting for uncertainties in outside temperature, hot water usage, and non-controllable net load. The authors approach the ADP-based HEMS via an effective combination of Sobol sampling backward induction and a K–D tree nearest neighbour techniques for the value function approximation. A subset of possible states is sampled and used to create an approximation of the value of being in aggregated states. They compare the ADP approach with other prevailing HEMS methods, including dynamic programming (DP) and mixed-integer linear programming (MILP), in a model predictive control framework. Simulation results show that the proposed ADP approach can yield near-optimal appliance schedules under uncertainties when finely discretised. Merits and drawbacks of the proposed ADP method in comparison with DP and MILP are also revealed.
Molecular, functional, and pathological aspects of TDP-43 fragmentation

Transactive response DNA binding protein 43 (TDP-43) is a DNA/RNA binding protein involved in transcriptional regulation and RNA processing. It is linked to sporadic and familial amyotrophic lateral sclerosis and frontotemporal lobar degeneration. TDP-43 is predominantly nuclear, but it translocates to the cytoplasm under pathological conditions. Cytoplasmic accumulation, phosphorylation, ubiquitination and truncation of TDP-43 are the main hallmarks of TDP-43 proteinopathies. Among these processes, the pathways leading to TDP-43 fragmentation remain poorly understood. We review here the molecular and biochemical properties of several TDP-43 fragments, the mechanisms and factors mediating their production, and their potential role in disease progression. We also address the presence of TDP-43 C-terminal fragments in several neurological disorders, including Alzheimer's disease, and highlight their respective implications. Finally, we discuss features of animal models expressing TDP-43 fragments as well as recent therapeutic strategies to approach TDP-43 truncation.
Scattered acoustic intensity field measurements of a rigid motionless sphere and cylinder

In this study, the properties of the scattered acoustic vector fields generated by a simple rigid motionless sphere and cylinder are investigated. Analytical solutions are derived from general acoustic pressure scattering models, and analyzed for wave numbers in the resonance region. The separable active and reactive components of the acoustic intensity are used to investigate the structural features of the scattered field components. The ability to extract scattered field features is illustrated with measurements obtained from in-air experiments using an anechoic chamber and acoustic intensity probes to measure the scattered acoustic vector field resulting from continuous plane wave illumination.
Development and use of an assembler in computer systems courses

Assembly language programming provides students the ability to manipulate bits and bytes inside a computer. But how do they know that the effect of their assembly language program is the same as what they have expected? If there is a way to `see' the bits and bytes after execution of their programs, they will understand more about that computer and its instructions. Therefore a simulator and an assembler for a basic computer, designed in Computer System Architecture (3rd Edition) by M. Morris Mano [1], was developed and used in our Computer Systems course. The background information about the basic computer, development of the simulator and the assembler, our experience in using them in our course, and benefits gained from using them are discussed.
Evaluation of basalt flows as a waste isolation medium

Activities in basalt waste isolation programs in the Columbia River basin are reported. Work during the period is summarized for the overall program which is divided into systems integration, geology, hydrology, engineered barriers studies, engineering testing, and the construction of a near-surface test facility. (JRD)
Pediatric reference ranges for glomerular filtration rate determined by a single injection of Tc-99m DTPA

1375 Objectives Radionuclide glomerular filtration rate (GFR) is a well-validated method to assess renal function, but there are no well-established pediatric reference ranges. The aim of this study is to establish reference values in children and young adults. Methods 190 reference subjects (median age 8y, range 1 months-25y) had GFR determination at Children’s Hospital from 2000 to 2008 including 175 patients undergoing pre-chemotherapy evaluation and 15 potential renal donors. GFR was determined with a single intravenous injection technique using 99mTc-DTPA. Serial blood samples at 2, 3, and 4 h were used to calculate GFR based on a single compartment model. Data were analyzed by age group, corrected for body surface area (BSA), and normalized to a BSA of 1.73m2. The 95% reference ranges were calculated as mean ± 2SD. Results GFR increased with age, likely reflecting increased renal mass. In all groups age ≥1y, the lower limit of the reference range is >65ml/min/1.73m2. The lower normalized GFR in subjects age Conclusions Reference ranges for GFR determined with a single injection of 99mTc-DTPA will be useful for the assessment of renal function in children and young adults, particularly in patients less than 1y of age.
Learning weights for weighted OWA operators

Weighted OWA (ordered weighted aggregation) operators were introduced as a generalization of the weighted mean (WM) and the OWA operators, so that the advantages of both could be used in a single data fusion function. In this work, we study the determination of their parameters when a set of examples is at our disposal. The approach presented in this paper is of interest in data mining when a certain variable has to be expressed in terms of some other ones. In this case, the learning of weights corresponds to fitting the model, and the weights correspond to the importance of the variables and of their values.
Understanding the Institutional-Level Factors of Urban School Quality:

Background/ContextThis article addresses which school-level factors contribute to school quality. Previous research has focused on assessing the effects of school-level variables on student-level q...
On the Origin of Jupiter's Atmosphere and the Volatiles on the Medicean Stars

One of Galileo’s greatest contributions to the history of ideas was his introduction of the experimental method in science. While most research in astrophysics cannot use this powerful approach, our newly won ability to explore the solar system with spacecraft gives us an opportunity to follow Galileo’s lead. Were he with us today, he would certainly applaud the rich harvest of results from the mission to Jupiter that bears his name. One imagines him calling “Encore! Encore!” We certainly hope we can comply—by sending more probes to other regions on this strikingly heterogeneous planet, while dropping experiment packages on those wonderful satellites to learn more about their compositions, internal structures, and interactions with the Jovian magnetosphere. There is so much more to do.
Aircraft Noise-Induced Building Vibrations

The outdoor/indoor noise levels and associated vibration levels resulting from aircraft and nonaircraft events are recorded at 11 homesites, a historic building, and a school. In addition, limited subjective tests are conducted to examine the human detection/annoyance thresholds for building vibration and rattle caused by aircraft noise. Results include relationships between aircraft noise and building vibration and between vibration and human response. Comparisons of building vibration data with existing criteria for building damage and human response are also considered.
What Bends Wide-Angle Tailed Radio Sources?

It has been generally assumed that wide-angle tailed (WAT) sources like 3C465 are formed in a manner similar to that of the more strongly bent U-shaped sources such as NGC 1265, i.e., by ram pressure arising from galaxy motion through a dense intracluster medium (ICM). The WAT sources were thought to be less strongly bent because of the smaller ratio of tail plasma flow momentum flux to galaxy velocity. However, as noted recently by Burns (1981), there is a serious discrepancy between the ram pressure model requirements for bending WATs and the dynamics of the associated radio galaxy. To bend the tails, we calculate that the galaxy must typically move at velocities of 0.7−1×103 km s-1 for distances comparable to the length of the radio tails (~200 kpc for 3C465). This implied galaxy motion is inconsistent with the nature of the massive cD galaxies generally associated with WATs. Cluster galaxy velocity data, X-ray observations, and recent models suggest that these giant galaxies are nearly at rest at the bottoms of cluster potential wells, at most moving ~200 km s-1 in an oscillatory motion of small amplitude (<0.3 of a core radius, Malumuth, 1981, private communication). Thus it appears that some other mechanism is responsible for bending WAT sources.
Multicenter Evaluation of AMPLICOR and Automated COBAS AMPLICOR CT/NG Tests for Neisseria gonorrhoeae

The fully automated COBAS AMPLICOR CT/NG and semiautomated AMPLICOR CT/NG tests were evaluated in a multicenter trial for their ability to detect Neisseria gonorrhoeae infections. Test performance compared to that of culturing was evaluated for 2,192 matched endocervical swab and urine specimens obtained from women and for 1,981 matched urethral swab and urine specimens obtained from men. Culture-negative, PCR-positive specimens that tested positive in a confirmatory PCR test for an alternative target sequence within the N. gonorrhoeae 16S rRNA gene were considered to be true positives. The overall prevalences of gonorrhea were 6.6% in women and 20.1% in men. The COBAS AMPLICOR and AMPLICOR formats yielded concordant results for 98.8% of the specimens and exhibited virtually identical sensitivities and specificities. The results that follow are for the COBAS AMPLICOR format. With the infected patient as the reference standard, the resolved sensitivities of PCR were 92.4% for endocervical swab specimens and 64.8% for female urine specimens. There were no significant differences in these rates between women with and without symptoms. Among symptomatic men, COBAS AMPLICOR sensitivities were 94.1% for urine and 98.1% for urethral swabs; for asymptomatic men, the results were 42.3 and 73.1%, respectively. In comparison, the sensitivities of culturing were 84.8% for endocervical specimens, 92.7% for symptomatic male urethral specimens, and only 46.2% for urethral specimens obtained from asymptomatic men. When PCR results were analyzed as if only a single test had been performed on a single specimen type, the resolved sensitivity was always higher. The resolved specificities of PCR were 99.5% for endocervical swab specimens, 99.8% for female urine specimens, 98.9% for male urethral swab specimens, and 99.9% for male urine specimens. The internal control revealed that 2.1% of specimens were inhibitory when initially tested. Nevertheless, valid results were obtained for 99.2% of specimens because 60.0% of the inhibitory specimens were not inhibitory when a second aliquot was tested. The COBAS AMPLICOR CT/NG test for N. gonorrhoeae exhibited high sensitivity and specificity with urethral swab and urine specimens from men and endocervical swab specimens from women and thus is well suited for diagnosing and screening for N. gonorrhoeae infection.
Promising best practices that lead to employment in vocational rehabilitation: Findings from a four-state multiple case study

The state-federal vocational rehabilitation (VR) program has been challenged to demonstrate the effectiveness of VR services provided to eligible consumers. State-federal VR agencies are under pressure to develop a foundation of evidence-based practices that lead to competitive employment outcomes for people with disabilities. This article provides a qualitative analysis of the organization structural elements and service delivery practices related to the provision of effective best practices that enhance employment outcomes for individuals with disabilities. Using a Consensual Qualitative Research (CQR) approach, a multi-stage qualitative analysis of four high performing state VR agencies was conducted to identify promising organizational and service delivery practices that facilitate employment outcomes. Twenty-nine practices were identified as being supportive of the successful outcomes of persons with disabilities being served by these agencies. The identified practices reflect unique and similar service patterns across the four VR agencies studied. Practices were divided into Promising Organizational Practices and Promising Service Delivery Practices. The culture of an organization is an important factor in the development and sustainability of innovative practices. Best practices reconsider traditional rehabilitation counselor roles and offer new methods for delivering services. Rigorous research and program evaluation are required to identify which practices will ultimately constitute evidence-based practices.
Differential sensitivity of infectious and defective-interfering particles of Sindbis virus to ultraviolet irradiation.

Abstract A quantitative assay for defective-interfering (DI) particles of Sindbis virus (SV) was developed and shown to have an efficiency comparable to that of the plaque assay for infective virus. The assay was used to quantitate the kinetics of ultraviolet inactivation of the interfering activity of DI particles. For SV BP19 (a virus stock produced by 19 serial undiluted passages in BHK cells) and SV A17 (produced by 7 serial undiluted passages in A. albopictus cells) the interfering activity was seven- and twofold, respectively, more resistant to inactivation by uv light than was infectivity. For the DI particles in SV BP19 the uv target size correlated very well with the size of the DI genome RNA (MW = 0.59 and 0.63 × 10 6 ) but for the DI particles in SV AP7 the uv target size was 25–30% smaller than the DI genome (MW = 3.2 × 10 6 ). These results suggest that the entire genome of the DI particle in SV AP7 may not be required for interference. In contrast to the results obtained with DI particles, the interfering capacity of a nondefective ts mutant was almost as sensitive to inactivation as was infectivity.
New XOR/XNOR and full adder circuits for low voltage, low power applications

Abstract In this paper, the new low voltage operation exclusive-OR and exclusive-NOR circuits are proposed and a new full adder circuit has been developed. Since the dynamic power dissipation in CMOS is proportional to Vdd2 low voltage operation of the circuit is an important issue. The main design objectives for these new circuits are low power dissipation and full voltage swing at a low supply voltage Vdd = 2V). Several XOR circuits have been fully simulated using HSPICE with a 0.4 μm CMOS technology at a low supply voltage. The proposed XOR and XNOR circuits are compared with previously known circuits and shown to provide superior performance. The low voltage full adder circuit has been implemented using the new XOR, XNOR and MUX circuits. The simulation shows that the new low voltage full adder has less power dissipation and a smaller power-delay product than previous full adder circuits.