cssi/SciSciGPT-SciSciNet huggingface dataset:
Assessing EM Patient Safety and Quality Improvement Milestones Using a Novel Debate Format.

Graduate medical education is increasingly focused on patient safety and quality improvement; training programs must adapt their curriculum to address these changes. We propose a novel curriculum for emergency medicine (EM) residency training programs specifically addressing patient safety, systems-based management, and practice-based performance improvement, called “EM Debates.” Following implementation of this educational curriculum, we performed a cross-sectional study to evaluate the curriculum through resident self-assessment. Additionally, a cross-sectional study to determine the ED clinical competency committee’s (CCC) ability to assess residents on specific competencies was performed. Residents were overall very positive towards the implementation of the debates. Of those participating in a debate, 71% felt that it improved their individual performance within a specific topic, and 100% of those that led a debate felt that they could propose an evidence-based approach to a specific topic. The CCC found that it was easier to assess milestones in patient safety, systems-based management, and practice-based performance improvement (sub-competencies 16, 17, and 19) compared to prior to the implementation of the debates. The debates have been a helpful venue to teach EM residents about patient safety concepts, identifying medical errors, and process improvement.
The Adriatic-Baltic Transversal: Danilo Kiš Through the Prism of Baltic Writing on Essentialism and Diversity

The purpose of this paper will be to compare the ideas of one highly regarded southeast European writer, Danilo Kis (1935–1989) of Yugoslavia, with those of some leading writers and thinkers from the Latvia, Estonia, and Lithuania. My analysis will center on the vague concepts of “identity” and “national culture”. I will explore, by reference to the many essays and interviews of Danilo Kis, concrete topics such as essentialism and linguistic and ethnic diversity and look for parallels or contrast in the works of some Baltic writers. These thoughts will, I hope, spark a discussion based on sources broader than those that I command about what terms such as identity and national culture actually mean and how they effect the production, or reputation, of writers. It should also be possible to look at some issues relating to cultural translation in Kis, because he grew up in the contested border area between Hungary and Serbia, was the product of an ethnically and religiously mixed marriage, and translated and taught internationally for much of his life.
Are Graduating Pediatric Residents Prepared to Engage in Obesity Prevention and Treatment

Abstract Background Little information is available to gauge residents' perceived receipt of comprehensive training and preparedness to manage children with obesity in practice. Methods A national, random sample of 1000 graduating pediatric residents were surveyed in 2013 on childhood overweight/obesity and preparedness to prevent and treat obesity. A composite training measure was created by summing the number of areas (10 possible) where training on overweight/obesity was received. Multivariable logistic regression explored relationships of resident and training characteristics to residents' belief that their own counseling on prevention and treatment of overweight/obesity is very effective (vs somewhat/slightly/not effective). Results Of 625 survey respondents (63% response), most (68–92%) reported receipt of training in each of 10 assessed areas on overweight/obesity prevention, assessment, and treatment. Most residents did not desire more training in the assessed areas; however, 54% wanted more training in motivational interviewing. About one-fourth believed that their own counseling on the prevention of overweight/obesity (26%) and treatment of obesity (22%) was very effective. Residents who rated their ability to use motivational interviewing as very good/excellent were more likely to rate their counseling on both the prevention and treatment of overweight/obesity as very effective (adjusted odds ratio [aOR] 4.33, 95% confidence interval [CI] 2.63–7.13; and aOR 4.69, 95% CI 2.72–8.07, respectively). Residents who received training in all 10 assessed areas were also more likely to rate their counseling on both prevention and treatment as very effective (aOR 2.58, 95% CI 1.61–4.14; aOR 2.41, 95% CI 1.46–3.97, respectively). Conclusions Comprehensive training on overweight/obesity and inclusion of training in motivational interviewing may help residents feel better prepared to care for children with overweight/obesity.
Defect Structures in Aluminosilicate Single-Walled Nanotubes: A Solid-State Nuclear Magnetic Resonance Investigation

We report a detailed investigation of the defect structures in aluminosilicate single-walled nanotubes via multiple advanced solid-state NMR techniques. A combination of 1H–29Si and 1H–27Al FSLG-HETCOR, 1H CRAMPS, and 1H–29Si CP/MAS experiments were employed to evaluate the proton environments around Al and Si atoms in the final nanotube structure. The 1H CRAMPS spectra of dehydrated aluminosilicate nanotubes revealed the proton environments in great detail. Integration of these results with the findings from the 1H–29Si and 1H–27Al FSLG-HETCOR and 1H–29Si CP/MAS data allows the structural assignment of all the chemical shifts and the identification of various types of defect structures in the aluminosilicate nanotube wall. In particular, we identify five main types of defect structures arising from specific atomic vacancies in the nanotube structure. It is estimated that ∼16% of Si atoms in the nanotube inner wall are involved in a defect structure. The characterization of the detailed structure of the n...
Design of Energy-Saving PZT Drive Amplifiers for Mobile and Wearable Physical Assists

An energy-efficient circuit for driving PZT actuators using a charge recovery technique is explored in this paper. Mobile and wearable devices for physical assists requiring extended battery life and/or minimal battery weight will benefit from this technology. PZT is a capacitive transducer and can produce constant force for extended periods with little power consumption. Furthermore, energy can be saved by moving charge from one PZT stack to another instead of draining to ground. This paper describes an efficient charge-recovery circuit that can capture 40∼65% of the energy in one PZT unit by transferring it to another PZT unit. The battery then must only supply the remaining charge thereby increasing battery life. First, the basic principle of the charge-recovery technique is described. The idealized circuit architecture and possible implementation are presented. Then, the electrical circuit behavior is analyzed. PZT hysteresis is discussed, and results are presented.© 2011 ASME
Dextran functionalization enhances nanoparticle-mediated siRNA delivery and silencing

Understanding the endocytosis and intracellular trafficking of short interfering RNA (siRNA) delivery vehicle complexes remains a critical bottleneck in designing siRNA delivery vehicles for highly active RNA interference (RNAi)-based therapeutics. In this study, we show that dextran functionalization of silica nanoparticles enhanced uptake and intracellular delivery of siRNAs in cultured cells. Using pharmacological inhibitors for endocytotic pathways, we determined that our complexes are endocytosed via a previously unreported mechanism for siRNA delivery in which dextran initiates scavenger receptor-mediated endocytosis through a clathrin/caveolin-independent process. Our findings suggest that siRNA delivery efficiency could be enhanced by incorporating dextran into existing delivery platforms to activate scavenger receptor activity across a variety of target cell types.
Is the Simple Law of Mobility Really a Law? Testing Clark's Hypothesis

Recent work by Gregory Clark and coauthors uses a new surnames approach to examine intergenerational mobility, nding much higher persistence rates than traditionally estimated. Clark proposes a model of social mobility to explain the diverging estimates, including the crucial but untested assumption that traditional estimates of intergenerational persistence are biased downward because they use only one measure (e.g., earnings) of underlying status. I test for evidence of this using an approach from Lubotsky and Wittenberg (2006), incorporating information from multiple measures into an estimate of intergenerational persistence with the least attenuation bias. Contrary to Clark’s prediction, I do not nd evidence of substantial bias in prior estimates.
Template matching tracking algorithm with position and orientation information of camera

While the image-guided target tracking system is tracking,image rotation,the changes of the scale of targets and imaging perspectives will cause tracking drift problems.In order to solve these problems,a method of correcting and updating the matching template using the position and orientation information of the camera was proposed.According to the relative position and orientation information of camera and targets,the objective perspective imaging model was established as well as the template correction equation of different camera position and orientation;the correction equation was decomposed into two parts which were the rotation of real-time image and the affine transformation of template to reduce the changes in error;the update strategy relative to the correlation coefficient and the distance information was designed to adapt to the changes while target tracking system was gradually close to the target.The algorithm had been validated using the flight simulation video generated by the visual-based simulation software Vega Prime.The experimental results show that the proposed algorithm can effectively adapt to the changes of the target scale,imaging perspective as well as image rotation while the image-guided tracking system is tracking,and it reduces the tracking drift.
Achieving multiple-order embryo transfer identifies women over 40 years of age with improved in vitro fertilization outcome

Objective To define factors in patients ≥40years that may improve outcome and provide prognosis for success in IVF-ET. Design Retrospective. Setting University infertility center. Patients Patients (n=501) undergoing IVF-ET from 1987 to 1994. Interventions IVF-ET (n=713cycles) with GnRH-analogue suppression and hMG stimulation. Main Outcome Measures We evaluated data including age, diagnosis, prestimulation (day 3) FSH and E 2 , hMG ampules used, days of monitoring, follicle number and size, maximum E 2 , ova retrieved, cancellation rate, clinical pregnancy, nidation, and miscarriage rates. Results Overall, patients ≥40years had significantly decreased pregnancy rates (PRs), response to stimulation, and increased miscarriage rates. However, if these patients had four or more embryos transferred, their response and PRs (34.4% per ET) were not significantly different from younger women (47.7% per ET). The majority (77.8%) of pregnancies in women ≥40years occurred when four or more embryos were transferred. Conclusion A subset (49%) of women ≥40years undergoing IVF-ET will respond to ovarian stimulation well enough to result in four or more embryos available for transfer with a resultant PR similar to that observed in younger patients. We recommend consideration of an attempt at IVF-ET before recommending oocyte donation.
Patterns in perinatal mortality. A study of 100 months.

A survey of 8½ years of perinatal mortality records from the Methodist Hospital of Dallas is presented. The presentation is motivated by the slow decline of perinatal mortality in the United States since 1950 and the lag of this decline behind that of western Europe. The survey encompasses 28,313 births and 689 perinatal deaths. Immaturity is found to be the largest single category and also to be associated with all other categories in 66 per cent of the deaths. The question is raised of a relationship between the increasing number of deaths from respiratory distress in the immature neonate and the amount of sedation and type of anesthesia used during premature labor and delivery.
Comparing International Student Friendship Networks in Buenos Aires: Direct Enrollment Programs vs. Study Abroad Centers.

A robust pattern identified in the cross-cultural adaptation and international education literature shows that upon arrival in a new cultural environment international students tend to form new friendships with individuals from their own countries while failing to develop relationships with those from the host country. This is problematic considering that communication with host nationals lies at the heart of the cross-cultural adaptation process and host national friendship is associated with a diverse set of positive outcomes. A historical debate among university administrators, international educators, and scholars as to the most effective way to arrange study abroad initiatives pivots around the amount of interaction that students have with the local culture. In order to examine the impact that study abroad program models have on friendship networks this study employs a mixed-method, longitudinal strategy to compare the friendship networks of 105 international students enrolled in 10 different study abroad programs and universities in Buenos Aires, Argentina. Results show that students studying directly at Argentine Public and Private Universities have significantly more Argentine and other international student friends while students in US-based Island programs have significantly more friends form their own country. These findings reveal the central role that study abroad administration plays in the interpersonal interaction that international students have with individuals from the host country, provide several explanations for the current trends, and give implications for study abroad administration.
Direct foaming and seeding of highly porous, lightweight gypsum

This paper describes the direct-foaming of plaster of Paris (CaSO4·½H2O) with up to 1.7 wt% of a nonionic surface-active agent to obtain highly porous, lightweight gypsum (CaSO4·2H2O) with 65–70% total porosity and a homogeneous, bimodal pore size distribution. Based on viscosity and temperature changes in the setting plaster of Paris slurry, the nonionic surfactant is seen to retard gypsum crystallization and thus extend the working time at higher water to solid ratios. The increase in viscosity during gypsum crystallization stabilizes the macropores formed during foaming. Gypsum foams of 32% density with a submicron matrix pore size, and relatively uniform macropore size of ∼100 µm were obtained. Seeding the process with 0.5 wt% 100 µm diameter gypsum particles accelerates gypsum crystallization in the presence of the nonionic surfactant and results in a more uniform, finer (92 µm) macropore structure due to less time for bubble coalescence.
Diffusion of tebuconazole into softwood under ambient conditions and its distribution in freshly treated and aged wood

Abstract Due to the nonhomogeneous nature of wood, diffusion of preservatives is a complex, multifactorial process. A proper understanding of this process is essential for the development of enhanced wood treatment protocols ensuring long-term stability of wood products. In order to assess the effectiveness of commercially used wood preservative treatments, the penetration of a representative radiolabeled fungicide in softwood was measured and then modeled using a double-logarithmic model. The longitudinal and surface penetration of 14C-labeled tebuconazole (TAZ) dissolved in a naphtha-based solvent was investigated at ambient pressure and temperature. Solvent and TAZ time dependent diffusion coefficients were estimated employing both experimental and computational methods using solvent mass uptake data spanning 6 months and complete TAZ immersion data spanning 3 min. Results obtained by these two methods were matching for short treatment times suggesting that the bulk of the TAZ traveled together with the solvent. No TAZ redistribution was observed in treated wood samples upon laboratory aging for 6 months other than subsurface evaporative losses.
Advances in Bio-inspired Tribology for Engineering Applications

Bio-inspired tribology is an interdisciplinary field of science where scientists and engineers seek to investigate and incorporate tribological properties encountered in biological beings into engineering applications. In this paper, bio-inspired tribological research that are speculated to have a huge impact on tribological applications have been reviewed. These research involve (1) investigations related to replication of lubricin found in synovial fluids of mammalian joints which have super-low friction values that can be utilized in IC engines, (2) surface replication concerning to superhydrophobic properties of gecko skin which is seen to have anti-wetting and self-cleaning properties, (3) friction-reducing shark skin through specialized nanoparticle coatings that is seen to give a different perspective on surface texturing, (4) new techniques, such as soft lithography to replicate surfaces of lotus leaf and air lubrication phenomenon inspired by emperor penguins that is being applied to propel boats, ships, and torpedoes faster by reducing skin friction underwater. Further, an investigation in self-healing materials inspired from pitcher plant that has led to the innovation of self-healing and slippery liquid-infused porous surfaces has been discussed. These research works reviewed not only provide a deep insight into the current advances in bio-inspired tribology but also helps understand the plausibility of the research applications in the future and the practicality of innovations possible.
Health-related quality of life and physiological measurements in achalasia.

The diagnosis of achalasia is generally made based on patient symptoms, the appearance of the esophagus on endoscopy and barium esophagogram, and esophageal manometry. In addition, timed barium esophagography (TBE) can give useful information on the clearance of liquid barium over a 10 minute period and the passage of a barium tablet. What is unclear is how well these physiological measurements of esophageal function correlate with patient-perceived health-related quality of life. Our aim was to assess whether objective physiological measurements of high-resolution manometry (HRM) and TBE will correlate with quantitative achalasia-related health-related quality of life (HRQoL) measurements. Patients referred for possible surgical treatment of achalasia were assessed preoperatively in the following manner. A gastroenterologist and surgeon clinically evaluated all patients. In addition to history and physical examination, patients underwent further testing with TBE, upper gastrointestinal endoscopy, and HRM. The diagnosis of achalasia was based on HRM. Prior to surgical treatment, patients completed the 'Measure of Achalasia Disease Severity' (ADS) which is a validated instrument assessing the severity of achalasia-associated HRQoL. Hundred and twenty patients were included in this study. The mean ADS score was 24.9 ± 3.6. There was no statistically significant difference in score among the achalasia types: I, 24.0 ± 4.3; II, 25.4 ± 3.2; III, 24.3 ± 4.6. Using linear regression analysis, there was no statistically significant correlation between ADS scores and TBE column height or width at 1 and 5 minutes. There was no statistically significant difference between patients who could pass a 13 mm barium tablet (26.4 ± 3.4) and those who could not (24.9 ± 3.6). There was no statistically significant correlation between LES pressure and IRP with ADS scores. There is poor correlation between patient-perceived health-related quality of life and objective physiological measurements of achalasia. Therefore, the assessment of treatment outcomes of achalasia will need to require both an assessment of esophageal physiology as well as HRQoL.
Thermal desalination membranes: Carbon nanotubes keep up the heat

Applying high-potential alternating current to a carbon-nanotube–polymer composite film provides a self-heating membrane that enhances desalination performance of high-salinity brines by membrane distillation.
Does the Visual Appeal of Instructional Media Affect Learners’ Motivation Toward Learning?

While authors like Mayer (2009) suggest that designers should avoid using visuals for the purpose of attracting learners’ interests, some scholars suggest that visuals could influence learners’ emotions. In this study the author investigated whether the perception of the visual appeal of instructional handouts affects learners’ self-reported motivation to learn from the handouts. Two handouts were prepared for this study: a minimalist handout following Mayer’s (2009) Coherence Principle and an appealing handout complying with everyday visual trends. Participants were instructed to look at the handouts in different orders according to groups and were asked about their impressions of the handouts. The appealing handout was perceived as motivating when it was seen after the minimalist handout. However, the group that saw the minimalist handout first did not perceive the appealing handout as motivating. The result implies that not only the design but also the learning context influences learners’ self-reported motivation to engage with the handout.
Employment and Housing Challenges Experienced by Sex Offenders during Reentry on Parole

Although the general offender populations are known to experience numerous barriers to successful community reentry from prison, existing research suggests that barriers for sex offenders may be pa...
Stress path with depletion in coalbed methane reservoirs and stress based permeability modeling

Abstract That permeability is a critical parameter dictating the performance of naturally fractured reservoirs, like coalbed methane (CBM), is evident form the available field, experimental and permeability modeling information in the literature. Although modeling is often achieved at the expense of several input parameters, the exercise is typically unable to match sudden increases in coal permeability, encountered in deep coals after significant depletion. This paper is aimed at coupling stress and permeability in order to reduce the number of parameters required for modeling the permeability variation. Stresses in the reservoir are translated to invariants and stress path of coal is established in octahedral effective stress plane. Based on a detailed analysis of the stress path of three different coal types, a permeability model is presented in terms of stresses alone, that is applicable for elastic as well as inelastic deformations of coal. The model is validated using pressure-dependent-permeability experimental data for three coal types along with the geomechanical testing data used to develop the failure envelope. The primary implication of the study is improved capability to predict permeability of deep coal deposits, given that they are likely to undergo inelastic deformation or shear failure with continued depletion, using one parameter only. Finally, realistic constraints on the values of the parameter are provided to enable operators with the necessary tools to use the model for field applications, particularly in the new and upcoming CBM fields.
Ecological Patterns Among Bacteria and Microbial Eukaryotes Derived from Network Analyses in a Low-Salinity Lake.

Microbial communities are comprised of complex assemblages of highly interactive taxa. We employed network analyses to identify and describe microbial interactions and co-occurrence patterns between microbial eukaryotes and bacteria at two locations within a low salinity (0.5–3.5 ppt) lake over an annual cycle. We previously documented that the microbial diversity and community composition within Lake Texoma, southwest USA, were significantly affected by both seasonal forces and a site-specific bloom of the harmful alga, Prymnesium parvum. We used network analyses to answer ecological questions involving both the bacterial and microbial eukaryotic datasets and to infer ecological relationships within the microbial communities. Patterns of connectivity at both locations reflected the seasonality of the lake including a large rain disturbance in May, while a comparison of the communities between locations revealed a localized response to the algal bloom. A network built from shared nodes (microbial operational taxonomic units and environmental variables) and correlations identified conserved associations at both locations within the lake. Using network analyses, we were able to detect disturbance events, characterize the ecological extent of a harmful algal bloom, and infer ecological relationships not apparent from diversity statistics alone.
Management Guidelines for Chronic Obstructive Pulmonary Disease

•COPD is a highly prevalent, under-diagnosed, under-treated and under-perceived disease. •COPD is a multicomponent disease. •COPD is a treatable disease. •Therapy is effective for the respiratory manifestations of COPD.
Flexner, Educational Reform, Social Accountability and Meta-Curriculum.

To the Editor: Frank Romanelli has written an important viewpoint titled, “Flexner, Educational Reform, and Pharmacy” that was published in the March 2017 issue of the Journal in which he points out that Flexner’s “relentless attention to task grounded in sound educational principles might
Does the HEDIS Asthma Measure Go Far Enough

Although measuring quality can lead tobeneficial outcomes, such as improved immuniza-tion coverage of young children triggered by defi-ciencies revealed through mandated qualityreporting, the cumulative impact may be “that theuse of techniques to measure the quality of care mayactually reduce the probability that high quality care. . . will be given.”
Metalloenzymes and Model Systems. Carbonic Anhydrase: Solvent and Buffer Participation, Isotope Effects, Activation Parameters and Anionic Inhibition

The interconversion between CO2 and HCO 3 - in the presence of bovine carbonic anhydrase (BCA) was studied by initial rate measurements using a stopped-flow indicator method. The results analyzed in terms of the Michaelis-Menten Scheme exhibited a sigmoidal variation of the turnover number (kcat) against pH with a pKa value of about 6.8 at 25.0°. For CO2 hydration large kcat values were observed in the high pH region, while for HCO 3 - dehydration large kcat values were observed in the low pH region. For both substrates Km values did not show any significant variation with pH in the region studied. Solvent deuterium isotope effects were found to be between 2.5 and 3.0 at 25.0° for both kcat and Km, and did not vary significantly with change of pH or substrate. Activation parameters for CO2 hydration catalyzed by H2O, OH-, and BCA were obtained in the temperature range 7.0°–35.0°C. For BCA catalysis, temperature effects were confined largely to kcat. Inhibition of BCA by monoanions was studied over a pH range of 6.6 to 9.0 for CO2 hydration, and 6.6 to 7.0 for HCO 3 - dehydration. Anions were found to exhibit linear mixed inhibition of CO2 hydration at low pH, linear uncompetitive inhibition of CO2 hydration at high pH, and linear competitive inhibition of HCO 3 - dehydration at all pH values studied. The implications of these results are discussed, a formal kinetic scheme is proposed, and a mechanism presented to account for these observations.
Propositions and the Philosophy of Language

I have selected an epistemological motive to provide a framework for discussing recent work in the philosophy of language. The motive is the search for an account of understanding the “content” of our belief and knowledge. I shall show how results in the philosophy of language are relevant to this search, thereby revealing what a large part of the philosophy of language is and why (in part) it is philosophical.1
Differences among religiously unaffiliated and Christians in the perceptions of the personality of Jesus

Previous research has demonstrated that Christians living in Korea and Christians living in the US differ in their perceptions of Jesus, in a manner that is aligned with cultural values. The presen...
Histone methyltransferase Ezh2 is critical for activation-induced CD8 T cell proliferation and survival (LYM7P.615)

Ezh2 catalyzes trimethylation of H3K27 and regulates transcriptional repression. It plays a vital role during stem cell development and cell differentiation. Although it is well documented that epigenetic changes regulate gene expression, the epigenetic mechanism during CD8 T cell differentiation are not fully understood. Here, we assessed the role of Ezh2 in CD8 T cell differentiation using Ezh2 T cells deficient mice (Ezh2-loxp/CD4-Cre, Ezh2 KO). The number of CD8+ T cells in the young Ezh2 KO were similar to wild-type (WT) mice. When infected with listeria-OVA, OVA+ CD8 T cells were not increased in Ezh2 KO compared to WT. This deficiency was further confirmed with the adoptive transfer of the OT-1 CD8 Tn cells into congenic mice with infection. We then examined CD8 T cell differentiation in vivo and in vitro. We found that CD8 Tn cells express activation-induced markers and cytokines similarly between Ezh2 KO and WT mice. However, CD8 Tn cells from Ezh2 KO mice showed impaired proliferation and enhanced apoptosis after activation compared to that of the WT mice. Genome-wide transcription analysis confirmed that Ezh2 KO CD8 T cells expressed significantly higher levels of cell cycle and apoptosis related genes than WT after activation. Collectively, these findings demonstrate that Ezh2 is required for repression of the transcriptional programs involved in cell proliferation and apoptosis during CD8 T cell activation and differentiation.
Leadership, Inside and Out: The Tideswell-AGS-ADGAP Emerging Leaders in Aging Program.

Author(s): Chang, Anna; Lundebjerg, Nancy E; Abrams, Joan; Barnes, Deborah E; Fain, Mindy J; Hall, William J; Johnson, Theodore M; Michael Harper, G; Williams, Brie; Ritchie, Christine S | Abstract: Background/objectivesTo optimize health and well-being for all older people, we must collectively develop leaders to pioneer models of care, educate the healthcare workforce, advance research, and engage the community.MethodsThe Emerging Leaders in Aging (ELIA) program was created to train a multiprofessional cadre of leaders focused on the health and well-being of older people. ELIA uses the social change curricular framework and addresses knowledge of self, community, and engagement with change. Program impact measured included scholar satisfaction, confidence related to curricular domains before and after the program, project progress, and scholar productivity.ResultsFour cohorts of 65 scholars in seven health professions from 24 states were selected for the year-long 55-hour program. Overall satisfaction from members of the first three cohorts who have completed the program (n = 46) was 4.86 (scale = 1-5), and scholar confidence increased from 5.8 to 8.0 (scale = 1-9) (p l .001). These scholars reported 85 presentations, 63 publications, and 21 awards subsequent to training. All scholars described the importance of a program focused on early and mid-career leaders in health and aging.DiscussionThe ELIA program leverages longitudinal, distance mentor communities, and project-based learning strategies. It has improved confidence and skills in emerging leaders who commit their efforts toward the care of older persons. Programs like ELIA are critical to preparing a healthcare workforce to optimize care for all as our health needs and expectations change with age. J Am Geriatr Soc 67:437-442, 2019.
10K Complexity and the Market Efficiency and Information Asymmetry Implications of Analysts’ Annual Earnings Forecasts

This paper examines whether 10K complexity has unintended consequences in terms of impairing price discovery in capital markets. More specifically, we examine the impact -- on market efficiency and information asymmetry -- of sell-side financial analysts’ first revised forecasts following publication of high- versus low-complexity 10Ks. We hypothesize that: (1) analyst underreaction to 10K-related information increases with complexity, (2) the impact of analyst underreaction on stock price efficiency increases with 10K complexity, and (3) the generally mitigating effect of analysts’ forecasts on information asymmetry documented in prior literature dissipates with 10K complexity. Our results are consistent with these hypotheses. Together, our results suggest that analyst forecasting behavior in response to complex 10K-related information constrains price discovery by creating market frictions due to market inefficiency and information asymmetry.
Segregation of two variants suggests the presence of autosomal dominant and recessive forms of WFS1-related disease within the same family: expanding the phenotypic spectrum of Wolfram Syndrome

Background WFS1 was initially described as causative agent of autosomal recessive (AR) Wolfram syndrome, a childhood-onset disorder involving diabetes, optic atrophy, hearing loss and neurodegenerative features. However, the discovery of autosomal dominant (AD) disorders caused by this gene has resulted in clinical counselling and result interpretation challenges. Objective We seek to report a family that appears to segregate dominant and recessive forms of WFS1-related disease. Methods/results A 19-year-old woman presented with progressive childhood sensorineural hearing loss and recent optic atrophy, with biallelic mutations in WFS1: c.2486T>C (likely pathogenic) and c.2470G>A (uncertain significance). Her A1C was normal. Her sister carried the same variants and had a similar phenotype. Their father carried c.2486T>C and was found to have mild–moderate hearing loss but no optic atrophy or neurological symptoms. The mother carried c.2470G>A and had a normal audiogram and ophthalmological exam. Providing anticipatory guidance for this family was difficult given the phenotypic variability of WFS1-related disorders and the uncertainty surrounding whether the inheritance pattern was AR or AD. Conclusion The clinical correlation of the variants identified in this family suggests an AR Wolfram-like syndrome, without the typical diabetes mellitus or diabetes insipidus nor neurological decline. To our knowledge, this is a novel WFS1-related phenotype.
Estimating Change in Tremor Amplitude Using Clinical Ratings: Recommendations for Clinical Trials

Tremor rating scales are the standard method for assessing tremor severity and clinical change due to treatment or disease progression. However, ratings and their changes are difficult to interpret without knowing the relationship between ratings and tremor amplitude (displacement or angular rotation), and the computation of percentage change in ratings relative to baseline is misleading because of the ordinal nature of these scales. For example, a reduction in tremor from rating 2 to rating 1 (0–4 scale) should not be interpreted as a 50% reduction in tremor amplitude, nor should a reduction in rating 4 to rating 3 be interpreted as a 25% reduction in tremor. Studies from several laboratories have found a logarithmic relationship between tremor ratings R and tremor amplitude T, measured with a motion transducer: logT = α·R + β, where α ≈ 0.5, β ≈ –2, and log is base 10. This relationship is consistent with the Weber–Fechner law of psychophysics, and from this equation, the fractional change in tremor amplitude for a given change in clinical ratings is derived: (Tf–Ti)/Ti=10α(Rf–Ri)–1, where the subscripts i and f refer to the initial and final values. For a 0–4 scale and α = 0.5, a 1-point reduction in tremor ratings is roughly a 68% reduction in tremor amplitude, regardless of the baseline tremor rating (e.g., 2 or 4). Similarly, a 2-point reduction is roughly a 90% reduction in tremor amplitude. These Weber–Fechner equations should be used in clinical trials for computing and interpreting change in tremor, assessed with clinical ratings.
Melanism as a potential thermal benefit in eastern fox squirrels (Sciurus niger)

Melanistic fox squirrels (Sciurus niger) have expanded westward and increased in frequency in the Omaha, Nebraska, and Council Bluffs, Iowa, metropolitan areas. The selective advantage of melanism is currently unknown, but thermal advantages have been hypothesized, especially in winter. No difference in metabolic response curves were measured between melanistic (black) and rufus (orange) fox squirrels. When exposed to sunny skies, both melanistic and rufus squirrels had higher surface (skin and fur) temperature as ambient temperatures increased. Melanistic squirrel surface temperatures did not differ when squirrels were exposed to sunny or cloudy skies. However, rufus individuals showed significantly lower increases in surface temperatures when under cloudy skies. During fall months, rufus individuals were about 1.5 times more active throughout the day than melanistic individuals. However, in winter, melanistic fox squirrels were approximately 30% more active in the mornings (before 13:00) compared to rufus squirrels. Pre-winter body condition was higher in melanistic (25.5 ± 1.8 g/cm) compared to rufus (20.30 ± 3.6 g/cm) fox squirrels; however, there were no significant differences between melanistic (22.8 ± 1.4 g/cm) and rufus (23.9 ± 0.8 g/cm) fox squirrel post-winter body condition. The results of this study indicate that melanistic fox squirrels may have a slight winter thermal advantage over rufus fox squirrels by maintaining higher skin temperatures.
Immunological effects of nivolumab immunotherapy in patients with oral cavity squamous cell carcinoma.

Although checkpoint blockades have become widely used, the immunological impact in cancer patients, especially those with oral cavity squamous cell carcinoma (OCSCC), has not been well studied. The present study assessed the immunological impact of anti-PD-1 (nivolumab) treatment in 10 patients with OCSCC. This involved phenotypic analyses of peripheral blood T-cell subpopulations and their expression of immune mediators prior to and following nivolumab treatment. The focus was on immunological effects of treatment without regard to possible clinical responses. Nivolumab caused a decline in the frequency of blood CD4+ cells but did not affect their expression of IFN-γ. However, nivolumab increased the proportion of CD4+ cells expressing the Treg-supporting factor Foxp3. Nivolumab treatment caused an increase in the proportion of CD8+ cells. While their expression of granzyme B increased, it did not attain significance. Analyses of CD8+ cell subpopulations showed nivolumab caused an increase in levels of unconventional CD8dimCD3+ T-cells. It also caused an increase in expression of granzyme B by these unconventional T-cells as well as by the conventional CD8hiCD3+ cells. The CD8hiCD3+ subpopulation also had a near-significant increase in IFN-γ expression. Treatment with nivolumab had no effect on the levels of the NK containing CD8dimCD3− subpopulation of cells or their expression of IFN-γ or granzyme B. These results show nivolumab causes opposing effects on CD4+ and CD8+ cell populations, with CD4+ cell levels declining but increasing the proportion of Treg cells, and unconventional CD8+ T-cell levels increasing with increased expression of immune mediators by CD8+ T-cell subpopulations.
A Single-Supply 6-Transistor Voltage Level Converter Design Reaching 8.18-fJ/Transition at 0.3–1.2-V Range or 44-fW Leakage at 0.8–2.5-V Range

This letter presents an ultralow-leakage level converter design based on dynamic leakage-suppression (DLS) logic for battery-less Internet-of-Things systems. The design is compact and simple, consisting of six transistors arranged as two digital buffers in series and requires only a single voltage supply corresponding to the high-voltage domain. We analyze the dc switching characteristic of the proposed level converter to create a design guideline which we use to implement two designs that target core (0.3-V to 1.2-V conversion) and I/O (0.8-V to 2.5-V conversion) voltage domains. We fabricated the designs in 65-nm CMOS and present measurements from 17 dies. The core design achieves 8.18 fJ per transition with 2.56 pW of leakage power, while the I/O design achieves 54.23 fJ per transition and 44 fW of leakage power.
Ionospheric Effects, Monitoring, and Mitigation Techniques

Radio waves such as the global navigation satellite system (GNSS) signals propagating through the ionosphere will experience varying levels of absorption, refraction, scattering, and polarization shift. The two remaining effects, refraction and scattering, have important impacts on GNSS and are the main focus of this chapter. The chapter discusses ionospheric scintillation effects at high and low latitudes and their mitigation techniques. For ionospheric monitoring stations, the first line of defense is to select antenna sites that have minimal multipath reflections and to use antennas that are designed to reject multipath. The chapter provides a review of the fundamental properties of the ionosphere that impact satellite navigation signals and position, velocity, and time solutions. It focuses on the refractive effects and provides information on the GNSS measurement model, the emphasis being on the ionospheric refraction and other error terms that cannot be directly separated from the ionospheric errors.
Mass–count plots for crystal size control

Abstract We present measurements from batch crystallization as a trajectory in the phase space mapped out by the crystal mass and the total chord count. This new perspective yields a framework for monitoring and controlling crystallization that has two beneficial attributes: first, crystallization is seen as movement—we find that this fosters an intuitive understanding of crystallization kinetics; and, second, the problem of controlling the average crystal size is cast as a trajectory-endpoint control problem—we find that this promotes the development of spatially-oriented control schemes. The utility of the proposed framework is demonstrated by application. In particular, we apply the framework to: 1) elucidate the effects of simple temperature manipulations on the crystallization kinetics; 2) interpret the actions applied by supersaturation control (SSC) and direct nucleation control (DNC) to produce large crystals; and 3) develop a control scheme—termed spatially-guided action trajectory endpoint control (sGATEC)—that can be applied to produce crystals of pre-selected average size.
Utility of Established Risk Models to Predict Surgical Mortality in Acute Type-A Aortic Dissection.

Objective The objective of this study was to determine the predictive value of 2 established risk models for surgical mortality in a contemporary cohort of patients undergoing repair of acute type-A aortic dissection. Design Retrospective analysis. Setting Single tertiary care hospital. Participants Seventy-nine consecutive patients undergoing emergent repair of acute type-A aortic dissection between 2008 and 2013. Intervention All patients underwent emergent repair of acute type-A aortic dissection. Measurements and Main Results The receiver operating characteristic curve was compared for each scoring system. Of the 79 patients undergoing emergent repair of acute type-A aortic dissection, 23 (29.1%) were above the age of 70. Seventeen (21.5%) patients presented with hypotension, 25 (31.6%) presented with limb ischemia, and 10 (12.7%) presented with evidence of visceral ischemia. Overall operative mortality was 16.5%. Increasing age was the only preoperative variable associated with increased operative mortality. The areas under the receiver operating characteristic curve for operative mortality was 0.62 and 0.66 for the scoring systems developed by Rampoldi et al and Centofanti et al, respectively. The area under the receiver operating characteristic curve for operative mortality for age was 0.67. The areas under the receiver operating characteristic curve for operative mortality between the 2 scoring systems and for age were not statistically different. Conclusions Existing predictive risk models for acute type-A aortic dissection provide moderate discriminatory power for operative mortality. Age as a single variable may provide equivalent discriminatory power for operative mortality as the established risk models.
Thermal poling studies in phosphate glasses

Summary form only given. The objective of our research is to introduce a second-order optical nonlinearity (/spl chi//sup (2)/) in phosphate glasses via the thermal poling technique, in order to enable the fabrication of integrated waveguide frequency-doubled lasers. The induced second order nonlinearities were measured via second harmonic generation using a fundamental beam from a 1064 nm mode locked Nd:YAG laser. We measure the phase-mismatch for SHG in phosphate glasses at 1064 nm.
Rosetta Ligand docking with flexible XML protocols.

RosettaLigand is premiere software for predicting how a protein and a small molecule interact. Benchmark studies demonstrate that 70% of the top scoring RosettaLigand predicted interfaces are within 2A RMSD from the crystal structure [1]. The latest release of Rosetta ligand software includes many new features, such as (1) docking of multiple ligands simultaneously, (2) representing ligands as fragments for greater flexibility, (3) redesign of the interface during docking, and (4) an XML script based interface that gives the user full control of the ligand docking protocol.
Radioimmunolocation of Hepatic and Pulmonary Metastasis of Human Colon Adenocarcinoma

We have established a large library of monoclonal antibodies against a human hepatoma cell line called FOCUS. One such monoclonal antibody (SF-25) detects a 125-kilodalton cell surface antigen found on FOCUS cells. As both the liver and the colon are of endodermal origin, we examined the possibility of expression in colon adenocarcinomas. This antigen was found in all 23 colon adenocarcinoma tissues surgically obtained but was absent in the adjacent normal mucosal counterpart as determined by a direct radioimmunohistologic technique. In the present study, we have established a model for human metastatic colon adenocarcinoma using the LS 180 cell line. Athymic mice were further immunosuppressed by intravenous injection of anti-NK cell antibodies (antiasialo GM1). After 24 h, mice were injected with LS 180 cells either via the tail vein or into the spleen followed by splenectomy. Macroscopic pulmonary and lymphatic metastasis developed within 2–3 wk after injection of cells and 9 of 10 mice died with advanced metastatic disease 2–3 wk later. In addition, macroscopic hepatic metastases were evident in 4 of 5 mice 3–4 wk after intrasplenic injection. Both hepatic as well as pulmonary and lymphatic tumor spread was localized by nuclear imaging with 125I-SF-25. Furthermore, micrometastases were detected by autoradiography 5–10 days later. Monoclonal antibody SF-25 is a potential candidate for tumor localization and the experimental metastatic colon cancer animal model may be useful for treatment evaluation of monoclonal antibody SF-25 either alone or in combination with other monoclonal antibodies when conjugated to radionucleotides and chemotherapeutic agents.
Mapping Loops onto Reconfigurable Architectures

Reconfigurable circuits and systems have evolved from application specific accelerators to a general purpose computing paradigm. But the algorithmic techniques and software tools are also heavily based on the hardware paradigm from which they have evolved. Loop statements in traditional programs consist of regular, repetitive computations which are the most likely candidates for performance enhancement using configurable hardware. This paper develops a formal methodology for mapping loops onto reconfigurable architectures. We develop a parameterized abstract model of reconfigurable architectures which is general enough to capture a wide range of configurable systems. Our abstract model is used to define and solve the problem of mapping loop statements onto reconfigurable architectures. We show a polynomial time algorithm to compute the optimal sequence of configurations for one important variant of the problem. We illustrate our approach by showing the mapping of an example loop statement.