cssi/SciSciGPT-SciSciNet huggingface dataset:
Complicated appendicitis--is the laparoscopic approach appropriate? A comparative study with the open approach: outcome in a community hospital setting

Good outcome has been reported with the laparoscopic approach in uncomplicated appendicitis, but a higher incidence of postoperative intraabdominal abscesses has been reported after laparoscopic appendectomy in complicated appendicitis. This retrospective comparative study compares outcome after laparoscopic (LA) and open appendectomy (OA) in complicated appendicitis. All patients who had LA or OA for complicated appendicitis between January 2003 and February 2006 were included in the study. Data collection included demographics, operative time, estimated blood loss, length of stay (LOS), complications, readmission, and reoperative rates. The primary end points for analysis were postoperative intraabdominal abscess and complication rates and secondary end points were LOS and operative time. All data were analyzed on an intent-to-treat basis. Of 104 patients, 43 patients underwent LA and 61 had OA. The mean age (24.8 +/- 16.5 versus 31.3 +/- 18.9, P = 0.08) in the LA group was lower than the OA group because there was a significantly higher proportion of pediatric patients (34.8% versus 14.8%, P = 0.02) who had LA. There was no significant difference in gender (female/male, 14/29 versus 27/34, P = 0.3) or American Society of Anesthesiologists class distribution (American Society of Anesthesiologists 1/2/3/4/, 35/7/1/0 versus 45/12/3/1, P = 0.68) between the two groups. The operative time (100.5 +/- 36.2 versus 81.5 +/- 29.5 minutes, P = 0.03) was significantly longer and the estimated blood loss (21 mL versus 33 mL, P = 0.01) was lower in LA when compared with OA, but there was no significant difference in the number of patients with preoperative peritonitis versus abscesses (7/36 versus 13/48, P = 0.6) in both groups. There was no difference in the median LOS (6 [interquartile range 5-9] versus 6 [interquartile range 4-8], P = 0.7) in the two groups. The conversion rate in LA was 18.6% (n = 8). There was also no significant difference in the complication (17/43 [39.5%] versus 21/61 [34.4%], P = 0.54), reoperative (3/43 [7%] versus 0/61 [0%], P = 0.07), and 30-day readmission (5/41 [11.6%] versus 3/61 [4.9%], P = 0.23) rates between the two groups. The rate of postoperative intraabdominal abscesses was significantly higher in the LA group when compared with the OA group (6/43 [14%] versus 0/61 [0%], P = 0.04) and the wound infection (1/43 [2.3%] versus 5/61 [8.2%], P = 0.4) and pulmonary complication (0/43 [0%] versus 3/61 [4.9%], P = 0.26) rate was higher in the OA group. There was no mortality in the LA group, but there was one mortality in the OA group resulting from postoperative myocardial infarction. Laparoscopic appendectomy can be performed in patients with complicated appendicitis with a comparative operative time, LOS, and complication rates but results in a significantly higher intraabdominal abscess rate and lower wound infection rate when compared with OA.
The Impact of Person-Organization Fit on Nurse Job Satisfaction and Patient Care Quality.

Abstract Purpose In the current healthcare context, large health care organizations may increasingly emphasize profit, biomedicine, efficiency, and customer service in the delivery of care. This orientation toward nursing work by large organizations may be perceived by nurses as incompatible with professional caring. Methods Ordinary Least Squares regression was used to explore the impact of person-organization fit (i.e., value congruence between self and employing organization) on nurses' general job satisfaction and quality of patient care ( n =753). Results Nurses' perceived person-organization fit is a significant predictor of general job satisfaction and quality of patient care. Conclusion The implications of our findings are discussed and recommendations for nursing leaders and future research are made.
Attention-Deficit Hyperactivity Disorder Status and Baseline Neurocognitive Performance in High School Athletes

Approximately 136,000 concussions occur annually in American high school sports. Neuropsychological data indicate that children with preexisting cognitive difficulties, such as attention-deficit hyperactivity disorder (ADHD), may have protracted recovery from concussion. ADHD, with an estimated prevalence of 11% in youth, may increase an athlete's vulnerability to sustaining sports-related traumatic brain injury (TBI). The preponderance of evidence focusing on TBI and ADHD has derived from motor vehicle accidents rather than sports-related incidents. Thus, it is paramount to explore how ADHD may relate to injury in the sports concussion context, as well as to assess how ADHD may affect baseline neurocognitive testing. Adolescent athletes with ADHD (n = 256) demonstrated significantly reduced Verbal Memory, Visual Motor, and Impulse Control index scores compared with their peers without ADHD (n = 256). Athletes with ADHD were nearly twice as likely to have sustained a prior concussion (ADHD, 14.1%; non-ADHD, 7.8%). Knowledge regarding the unique neurocognitive profile of athletes with ADHD may enhance clinical management decisions.
Mortality in Progeny in Relation to Egg Production of Dams

Abstract IN AN ANALYSIS of the egg production data of the daughters of Rhode Island Red and White Leghorn selected dams, the results of which have been reported by Jull (1933 Jull (1934), it was found that there was greater mortality among the daughters of dams whose records of egg production were above the mean egg production of the dams in each pen than among the daughters of dams whose records of egg production were below the mean egg production of the dams in each pen. Since the two papers cited previously dealt with the significance of progeny testing in breeding for egg production, the mortality data were reserved for subsequent discussion. This paper, therefore, deals with the mortality data of the pullets and with certain egg production data of the pullets that died in comparison with that of the pullets that lived. The basis on which the dams were selected for . . .
An autohemolytic agent in fetal liver extracts.

Summary(1) A saline extract of the liver of fetal guinea pig possesses greater hemolytic activity than a similarly prepared extract of maternal liver, as determined after 4 hours incubation at 38°C.(2) The activity, for the most part, is due to a heat-sensitive agent and, to a lesser extent, to a heat-resistant substance.(3) The lytic action of such extracts is not species-specific. It will lyse red cells from the same fetus, as well as those from the mother or from another species.
Law and Lawyering: Legal Studies with an Interactive Focus

A microanalysis of simulated examples of informal advocacy is presented to explore the effects that narrative choices and interactive signals of deference or dominance influence the effects of a legal advocate’s speech.
Training Future Dentists for an Academic Career: A Three-Tiered Model

The anticipated shortage of dental faculty presents a challenge for dental education as it will greatly impact the training of the next generation of practicing dentists. One way to alleviate shortages is to identify students who are interested in an academic career at the predoctoral level and provide them with training in teaching, research, and leadership. Based on available evidence, formal programs offer the best way to introduce students to academia as a viable career path. A well-designed program can also equip interested students with the necessary skills and basic knowledge to facilitate starting an academic career. The University of Pittsburgh School of Dental Medicine has developed a three-tiered model for providing its dental students with exposure to and training in academic dentistry. The three tiers reflect differing levels of commitment: 1) a two-year academic career track program, 2) academic career track elective courses, and 3) extracurricular activities. The aim of this study was to provide an initial assessment of the program's overall effectiveness. Data were collected using student and faculty surveys and student applications for the two-year academic career track program. The data gathered included characteristics of, and feedback from, students taking the elective courses, as well as student and faculty feedback about student teacher effectiveness. The study found overall positive responses to the three-tiered program from faculty, students, and student teachers at this initial stage. Whether these students ultimately become faculty members (the ultimate goal of the program) will be assessed in the future.
Simulation of Fire Spread of Typical External Wall Insulation Materials in High-rise Building

Organic insulation materials are widely used in the external wall insulation system of high-rise buildings,but it also increases the risk of external wall fire.This paper,based on computer simulation,focuses attention mainly on the fire spread rate,mass loss rate,temperature distribution and other characteristics of one of the insulation materials Expanded Polystyrene(EPS).The study found that after the ignition of the external insulation material,in a very short period of time,fire spreads to the entire surface from bottom up,and has a feature of skin burning.Upward fire spread dominates before it reached the top of the material.The central region of the material was remarkably burned off.While the upper ends of the material continued to burn,accelerating the trend of downwards spread,then fire spreads downwards intensely along the middle of inside material and materials burned into a V-shape until extinguished.The burning rate curve is similar under different ignition points as to the fire spread of external insulation materials in high-rise building,forming two peaks.
Composite mantle cell lymphoma and chronic lymphocytic leukemia/small lymphocytic lymphoma.

Background Composite mantle cell lymphoma (MCL) and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is rare, as less than 20 cases have been reported so far. However, this entity may be under-diagnosed because the two lymphomas are very similar in morphology and immunophenotype. Previous cases were mostly diagnosed with immunohistochemistry, but flow cytometry may play an important role in the detection of two tumors in the same specimen, thus achieving an accurate diagnosis. By definition, a composite lymphoma is two demarcated lymphomas occurring at the same anatomic site. Therefore, immunohistochemistry is still needed to identify the topographic relation of these two tumors. Our reported case illustrates the pitfalls in the diagnostic process and we recommend two standard panels with new markers for an accurate diagnosis of this composite lymphoma. Method: FACSCanto II is used with antibodies, including CD5, CD10, CD19, CD20, CD22, CD23, CD43, CD79b, CD200, kappa and lambda. Immunohistochemical stains include PAX-5/CD5 dual stain, Cyclin D1, SOX11, and LEF-1. Results: CLL/SLL is positive for CD5, CD19, CD23, CD43 and CD200, with dim expression of CD20, CD22, CD79b and kappa. MCL is positive for CD5, CD19, CD20, CD22, CD79b, kappa, and negative for CD23, CD43 and CD200. Immunohistochemical stains show that PAX-5/CD5 stains the entire tumor population. Cyclin D1 and SOX11 only stain the central portion that represents MCL and LEF-1 stains the periphery that represents CLL/SLL. Conclusions: We recommend the use of the above panels for flow cytometry and immunohistochemistry, respectively. LEF-1 is specific for CLL/SLL; and CD200 is helpful to distinguish CLL/SLL from MCL. This article is protected by copyright. All rights reserved.
AQP4 Antibody-Seropositive Neuromyelitis Optica in a Pediatric Patient Presenting with Severe Generalized Pruritus and Behavior Changes (P5.140)

Objective: Describe a pediatric case of AQP4-Ab positive Neuromyelitis Optica presenting with hypersomnolence, pruritus, left hemiparesis and behavior changes with review of literature. Background: Neuromyelitis optica (NMO) is a rare inflammatory, progressive demyelinating disorder typically presenting with optic neuritis and transverse myelitis, predominantly affecting females. Methods: 14-year-old Guyanese girl with no prior neurological or psychiatric history presented with progressively worsening hypersomnolence, left sided weakness, severe generalized pruritus and back pain. MRI showed abnormal signal within the deep gray nuclei, thalamus and spinal cord without definite enhancement. CSF analysis was unremarkable with negative oligoclonal bands. She improved after a course of high dose steroids and IVIG. Neuropsychiatric abnormalities continued with infantile behaviors, irritability, poor impulse control and suicidal ideation resolving completely after several months. She presented with a second clinically isolated syndrome (CIS) 10 months later with bilateral VI nerve palsy. MRI showed new lesions in the dorsal brainstem with resolution of previous lesions. Clinical symptoms resolved with high dose IV corticosteroids. Another CIS occurred 5 months later where she presented with diplopia and left leg weakness. Second lumbar puncture revealed positive oligoclonal bands. She was found to have positive anti-NMO antibody titers. MRI showed new enhancing signal abnormality along the left brachium pontis and thoracic spinal cord. She responded to high dose corticosteroids, IVIG and Rituximab. Conclusion: Early diagnosis of AQP4 antibody-seropositive NMO is imperative because it may lead to permanent visual impairment and physical disability. Low threshold for AQP4-Ab testing should be considered in pediatric demyelinating disease. Unexplained pruritus may be a rare manifestation of NMO, described in 12-27.4[percnt] in adult case series. Neuroanatomic basis for the pruritus is unclear but thought to be brainstem manifestation or “itch specific neurons” in the dorsal horns. Hypersomnia is seen with bilateral hypothalamic lesions. Disclosure: Dr. Ng has nothing to disclose. Dr. Karkare has nothing to disclose.
The Engine of Enterprise: Credit in America: Rowena Olegario, Cambridge, MA: Harvard University Press 301 pp., $39.95, ISBN 9780674051140 Publication Date: February 2016

The founders were no wiser than we “about keeping out of debt,” but they, and their contemporaries, disagreed about the role of credit in American society (9). Americans, in fact, have always had m...
Abstract 56: Thrombin Induces Protease-Activated Receptor 1 and PAR4 Heterodimers

Thrombin is a potent platelet agonist. Thrombin activates platelets and other cells of the cardiovascular system by cleaving its receptors, protease activated receptor 1 (PAR1), PAR4 or both. PARs are G-protein coupled receptors that activate cellular signaling through Gq and G12/13. Our previous studies have determined that PAR4 forms homodimers and have mapped the homodimer interface to specific residues in transmembrane helix 4 (TM4). We have also shown that coexpression of PAR1 with PAR4 lowers the threshold for PAR4 activation by thrombin ∼10-fold. The purpose of the current study is to examine the physical interaction between PAR1 and PAR4 and how these interactions influence PAR1’s ability to enhance PAR4 activation. The PAR1-PAR4 heterodimers were examined by bioluminescence resonance energy transfer (BRET). PAR1-PAR4 heterodimers were not detected under basal conditions. However, when the cells were stimulated with 10 nM thrombin, we were able to detect a strong interaction between PAR1 and PAR4. In contrast, stimulating PAR1, PAR4, or both with agonist peptides TFLLRN (100 microM) or AYPGKF (500 microM), respectively did not induce heterodimers. Further, point mutations that prevent PAR1 or PAR4 cleavage did not from heterodimers when stimulated with thrombin. Other proteases that activate PAR1 or PAR4 such as activated protein C (APC) and plasmin do not induce PAR1-PAR4 heterodimers. Finally, we have introduced point mutations in transmembrane helix 4 of PAR1 and PAR4 that prevent heterodimer formation when stimulated with thrombin. These data demonstrate that PAR1 and PAR4 require allosteric changes induced by receptor cleavage by thrombin to mediate heterodimer formation and have determined the PAR1-PAR4 heterodimer interface. Taken together, these data suggest that PAR1 and PAR4 have a dynamic interaction depending on the context of their expression. Since PAR1 is an attractive antiplatelet target, the molecular interactions of this receptor on the cells surface must be taken into account when developing and characterizing these antagonists.
Corrosion barriers for silver-based telescope mirrors comparing PEALD and PVD of AlOx

Astronomical telescopes continue to demand high-endurance high-reflectivity silver mirrors that can withstand years of exposure in earth-based observatory environments. The University of California Observatories Astronomical Coatings Lab has undertaken development of protected silver coatings suitable for telescope mirrors that maintain high reflectivity at wavelengths from 340 nm through the mid-infrared spectrum. We present promising results of enhanced corrosion barriers using plasma-enhanced atomic layer deposition (PEALD) of aluminum oxide (AlOx) as a top barrier layer. Novel coating recipes developed with ion-assisted electron beam deposition (IAEBD) of materials including yttrium fluoride and oxides of yttrium, tantalum, and silicon are used to compare the endurance of physical vapor deposition-grown barriers with PEALD-grown barriers of similar thickness. Samples of these mirror coatings were covered with conformal layers of AlOx deposited by PEALD using trimethylaluminum as a metal precursor and plasma-activated oxygen as an oxidant gas. Samples of coating recipes with and without PEALD oxide undergo aggressive high temperature/high humidity (HTHH) environmental testing in which samples are exposed to an environment of 80% humidity at 80°C for ten days in a simple test set-up. HTHH testing show visible results suggesting that the PEALD oxide offers enhanced robust protection against chemical corrosion and moisture from an accelerated aging environment. Mirror samples are further characterized by reflectivity/absorption before and after deposition of oxide coatings. AlOx is suitable for many applications and has been the initial material choice for this study.
Dynamical systems, ergodicity, and posterior matching

The Posterior Matching (PM) scheme is a mutual information maximizing scheme for efficiently communicating a message point in a continuum over a noisy channel with causal feedback. It was originally developed when the message point was on a subset of the real line, and we more recently generalized the framework to arbitrary dimensions with optimal trasnsport theory. Here, we consider a class of encoder dynamical systems constructed with optimal transport and show that the ergodicity of the aforementioned state variable is a necessary and sufficient condition for posterior matching to be reliable. Lastly, we show a surprising “all or nothing” result: this same ergodicity condition is necessary and sufficient to achieve capacity.
CLEAVAGE OF VICINAL DIOLS BY LIVER MICROSOMES

Publisher Summary This chapter describes a reaction catalyzed by a rat microsomal enzyme that causes the cleavage of a vic-diol to two moles of carbonyl derivative. The reaction requires either nicotinamide adenine dinucleotide phosphate-oxidase (NADPH) or nicotinamide adenine dinucleotide (NADH). An enzyme appears to be present in the microsomal fraction that catalyzes the cleavage of xenobiotic vic-diols. This enzyme has many similarities to P-450 oxygenase but they are unrelated to each other. It is an oxidation enzyme that catalyzes a reverse pinacol synthesis but without an apparent oxidant. It requires a reduced pyridine nucleotide as cofactor. The cleavage of DES-diol by this enzyme is relatively fast. As vic-diols—dihydrodiols—are oxygenation products of unsaturated aliphatics and aromatics by P-450 oxygenase present in the same subcellular fraction, they can also be cleaved by this enzyme to ketones or aldehydes. However, the implications of this possibility cannot be predicted.
Flexible Pavement Interface Bonding: Theoretical Analysis and Shear-Strength Measurement

It has been proven that the interface bonding between asphalt layers is critical to flexible pavement performance, especially for pavement overlays. However, the requirement on interface bonding strength has not been specified to prevent premature pavement failure, such as slippage cracking or early fatigue cracking. In this paper, pavement structural analysis was conducted to predict the interface shear stress between the surface and intermediate asphalt layers under the combination of vertical and horizontal loading at different temperatures. The effect of interface debonding on pavement life was quantified using the state-of-art mechanistic–empirical pavement-analysis software (AASHTO Pavement-ME) with local parameters. Field cores were taken to measure the interface bonding strength; using the direct shear device theoretical analysis, results show that the minimum-bond-strength requirement should be around 70 psi to prevent premature pavement failure, such as slippage cracking or fatigue cracking. This requirement can be easily achieved in field projects based on the testing results of bond strength from field cores.
The effect of incentives on intrinsic motivation and employee attitudes: A multilevel study across nations and cultural clusters

In a study of employees across 29 nations and 9 of the 10 Global Leadership and Organizational Effectiveness (GLOBE) cultural clusters, the association between economic and psychological incentives and intrinsic motivation, job satisfaction, and organizational commitment were examined. Self-Determination Theory (SDT) is utilized to develop a theoretical model and then compare structural relationships across nations and cultural clusters. Results confirm the positive relationship between basic psychological needs and intrinsic motivation across all nations and cultures. However there is an effect of cultural cluster on the relationships between incentives and motivation, wherein external incentives are intrinsically motivating in Southern and Confucian Asian clusters. The implications for the design of incentive systems are discussed.
What are emotions? A physical theory.

This article suggests a way of defining emotion on the basis of the work of John Dewey and Nina Bull. Oddly, emotions go undefined in most current emotion research, creating chaos. Unlike Dewey, Bu...
Posttraumatic stress disorder — the neuroscientific basis of evidence-based treatments

Posttraumatic stress disorder (PTSD) is a relatively common anxiety spectrum syndrome, in which memory of a triggering trauma becomes aberrantly linked to autonomic and emotional arousal. The recurrent, internally generated stress response can produce enduring behavioral and brain changes. Mechanistically, this may involve both dysregulation of the hypothalamo-pituitaryadrenal axis as well as degradation of the capacity of supramodal cortical areas to process and manage trauma-related emotional content. The optimal balance of information processing and hence behavioral reactivity shifts from the refl ective prefrontal cortex in favor of the more emotionally reactive amygdala. Trauma-focused therapies exploit adaptive neuroplasticity to decouple the memory of the trauma from the aberrant emotional and behavioral responses, in effect reconfi guring brain networks. The effect-size of such psychological therapies is generally larger than that for pharmacological treatments which are currently limited to drugs repurposed for PTSD. Nonetheless, in a signifi cant number of patients, some symptoms can be at least partially attenuated by selective serotonin reuptake inhibitors. In addition, the frequency and intensity of trauma-related nightmares can usually be lowered by adrenergic alpha-1 receptor agonists. Even as novel modalities continue to be developed, the judicious implementation of currently available evidence-based treatments for PTSD can target the underlying neurobiology, provide symptomatic relief, and promote psychosocial recovery.
A framework for developing metrics of youth engagement in informal learning environments

This paper proposes a framework which aims to leverage data from informal learning environments to provide insights about youth engagement for various stakeholders. To explore the framework, we created metrics to examine the engagement of 98 middle school-aged girls during a 20-week STEM program using attendance records and log data from an online learning platform coded to reflect 21st century learning activities. We present preliminary analyses using the metrics, focusing on how they can help stakeholders understand engagement and equity of participation.
Transitions of Care

Value-based purchasing requires healthcare systems to strategize by considering all elements of the continuum of care. Covered beneficiaries enrolled in the health system must be efficiently managed at each level of care and appropriate communication, acknowledgment, and respect for each component along the healthcare continuum are essential for optimum patient experience of care, quality performance, and value.
Infusing the Study of Social Responsibilities with an Intersectional Approach.

Social responsibilities are a central component of adolescents' and young adults' development, particularly for those from immigrant backgrounds. Social responsibility-a sense of responsibility and duty that extends beyond the self (Wray-Lake & Syvertsen, 2011) includes both family obligations (Fuligni, 2001; 2007) and community engagement (Jensen, 2008; Lerner et al., 2002). What is often missing, however, are the ways in which social identities and social inequality shape young adult's development of social responsibilities. An intersectional perspective (Crenshaw, 1989; Cole, 2009) is particularly well-suited to do so. Therefore, this manuscript discusses the ways in which an intersectional approach can augment studies of social responsibilities, highlights progress and challenges in the field, and outlines future directions. The majority of extant literature focuses on "single-axis" (Bowleg, 2008) static demographic features such as ethnic group differences in values of social responsibilities. An intersectional approach could more meaningfully attend to the ways in which ethnicity, sexual orientation, gender, SES, and immigration status come together to shape experiences of social responsibilities. In addition, taking an intersectional approach can provide the tools necessary to understand how social inequality shapes opportunities and necessity for social responsibilities. Future directions for the field are discussed including design, methodological, and analytic choices in conducting future work.
New Systems for Waste Processing of Tritium-Containing Gases at the Savannah River Site

A project to relocate and consolidate tritium processing activities from old, second generation buildings to newer buildings was initiated in the late 1990's at the Savannah River Site. The new waste gas processing systems located in the newer facility utilize recent technology, including metal getters, an innovative permeator design, and TCAP (Thermal Cycling Absorption Process) technology for removal of residual tritium prior to releasing the effluent to the environment. Startup testing results (using protium and deuterium) and corresponding lessons learned for these systems are presented. These systems have since successfully completed tritium startup testing and are operational.
Assessing Depression and Suicidality in Asian-Americans

This chapter provides a review of the most commonly used measures of depression and suicidality among Asian-Americans. The goal of the chapter is to inform clinicians about the psychometric properties of instruments assessing depression and suicidality among Asian-Americans. We examine the reliability, validity, and utility of the Center for Epidemiological Studies—Depression, Beck Depression Inventory, Geriatric Depression Scale, Hamilton Rating Scale of Depression, Patient Health Questionnaire-9, and Zung Self-Rating Depression Scale. Given the dearth of literature on suicidality measures, the chapter briefly reviews a few instruments that have been used in Asian samples. Most of the measures demonstrated adequate psychometric properties and could be used in their original form or with minor alterations (e.g., remove positively worded items). However, all of the measures need to be used with caution with Asian-American clients and complemented with culturally sensitive diagnostic interviews. More research is needed to establish the measurement equivalence (internal validity) and specificity and sensitivity (external validity) of the available depression and suicide measures for Asian-Americans.
The Potential of Experiential Learning Models and Practices In Career and Technical Education & Career and Technical Teacher Education

Since inception, career and technical education programs have embraced experiential learning as a true learning methodology for students to obtain occupational skills valued by employers. Programs have integrated classroom instruction with laboratory experiences to provide students a significant opportunity to learn. However, it is questionable as to the level of authentic experiential learning instructional practices that are actually taking place. This paper explores the tenets of experiential learning and considers the application of true experiential learning pedagogy into secondary career and technical programs along with teacher education programs in career and technical education. If the concept of experiential learning instructional pedagogy is to provide an authentic context in which students can benefit from it, educators should expand their knowledge of implementing experiential learning into their programs. Additionally, career and technical education teacher educators may enhance their programs by providing instruction to pre-service teachers in authentic experiential learning pedagogy.
Potential Issues for Interplanetary and Interstellar Trade

If and when interplanetary and interstellar trade develops, it will be novel in two respects. First, the distances and time spans involved will reduce all or nearly all trade to the exchange of intangible goods. That threatens the possibility of conducting business in a genuinely common currency and of enforcing debt agreements incurred by governments. Second, interstellar trade suggests trade between humans and aliens. Cultural distance is a probable obstacle to initiating and sustaining such trade. Such exchange also threatens the release of new and dangerous memes.
Cultural Competence of Baccalaureate Nurse Faculty: Relationship to Cultural Experiences.

Abstract Background Introducing and fostering cultural competence development in nursing students only may occur with well-qualified, committed nurse faculty who are self-aware of their own cultural values and beliefs, unfortunately, there is limited research on the factors that influence the development of nurse faculty cultural competence. Purpose and methods This descriptive, correlational study examined cultural experiences of 118 full-time nurse faculty in the United States (U.S.). Marianne Jeffreys’ Cultural Competence and Confidence (CCC) model was used to examine cultural experiences and transcultural self-efficacy (TSE), or confidence. Jeffrey's Transcultural Self-Efficacy Tool (TSET) was used to measure nurse faculty cognitive, affective, and practical nursing skills as influenced by cultural experiences. Results Results indicate that nurse faculty are most confident about their attitudes (8.61), and least confident about their transcultural knowledge (7.39). Study results identified nurse faculty TSE as influenced by cultural experiences within the U.S. (rs = 0.23, p Conclusions Nurse faculty are most confident about their attitudes and least confident about their transcultural knowledge. The results of this study indicate that nurse faculty cultural experiences within the U.S., development in teaching cultural nursing care concepts, and preparation in training and workshops influence nurse faculty TSE and overall cultural competence.
Efficiently Capturing Weak Interactions in ab Initio Molecular Dynamics with on-the-Fly Basis Set Extrapolation

Weak interactions have a critical role in accurately portraying conformational change. However, the computational study of these often requires large basis electronic structure calculations that are generally cost-prohibitive within ab initio molecular dynamics. Here, we present a new approach to efficiently obtain AIMD trajectories in agreement with large, triple-ζ, polarized valence basis functions, at much reduced computational cost. For example, it follows from our studies that AIMD trajectories can indeed be constructed in agreement with basis sets such as 6-311++G(2df,2pd) with computational effort commensurate with those from much smaller basis sets such as 6-31+G(d), for polypeptide systems with 100+ atoms. The method is based on molecular fragmentation and allows a range-specified repartitioning of intramolecular (and potentially intermolecular) interactions where noncovalent interactions are selectively assembled using a piece-wise reconstruction based on a set-theoretic inclusion-exclusion principle generalization of ONIOM. Through a simplex decomposition of molecular systems the approach efficiently provides the necessary many-body interactions to faithfully represent noncovalent interactions at the large basis limit. Conformational stabilization energies are provided at close to the complete-basis limit at much reduced cost, and similarly AIMD trajectories (both Born-Oppenheimer and Car-Parrinello-type) are obtained in agreement with very large basis set sizes, in an extremely efficient and accurate manner. The method is demonstrated through simulations on polypeptide fragments of a variety of sizes.
Benefits of Using The Pause after Death in Emergency Departments: A Delphi Study.

Objective The Pause is a short-term, microbreak created by an emergency nurse in 2009. It provides care team members a few seconds of silence to honor a patient who has died while also honoring the efforts of the team. It is used now on four continents as a standard of care. We investigated how it is being used and why. Methods We used a modified Delphi methodology with purposive sampling and a descriptive approach. During the three-round Delphi, we created a data display using open, then axial coding to develop a thematic analysis. Member checking and reflexivity exercises were used to build reliability and trustworthiness of findings. Results We analyzed 21 transcripts. The Pause is reported to be an ongoing practice in at least 23 health systems globally. Key themes such as Benefits, Self-Care, and Support of other Patients were most pertinent in our analysis. Conclusion The Pause is a low-risk, grassroots intervention that can be led by any member of a care team in emergency settings. It offers self-care for the individual and team. It helps emergency providers feel grounded after a death before going to treat another patient. According to our sample, The Pause helps reduce caregiver stress, which may decrease the risk for burnout. Although further research is recommended, we assert that The Pause be used as a standard of care in emergency departments across the United States.
Designing and Conducting Quality Research in Mathematics Education: Building a Program

This chapter addresses a significant issue that novice mathematics education researchers confront: how to conceptualize, design, and conduct a quality, comprehensive, research program. Developing, executing, and sharing the results and the process of one’s research program is a primary professional commitment for all researchers. For novice mathematics education researchers, a primary challenge may be how best to navigate the intellectual terrain of their focus of inquiry and also to acknowledge that they are not alone in initially experiencing rejection, frustration, confusion, and doubt but that successes will follow. Conceptualizing and launching one’s research program, one that is both original and generative, is an issue that all researchers have faced in their careers. We encourage beginning researchers to think broadly and creatively about the opportunities to share and to bring new expertise to their work by expanding their community of researchers. In this chapter, we provide insights and suggestions regarding how novice mathematics researchers may reflect upon, construct, and sustain a research program that is both original and generative. Throughout this chapter, we offer detailed examples from our research program in mathematics education to illustrate this process. We report on decisions made and the conditions that prompted the directions we took.
Speed of processing training and depression in assisted and independent living: A randomized controlled trial.

Late life depression is widely associated with lower quality of life and greater disability, making it an important target for prevention. Earlier randomized controlled trials [RCTs] demonstrated that speed of processing training [SOPT] led to reductions in depressive symptoms and clinical depression in community-dwelling adults. Our purpose was to evaluate depression outcomes related to SOPT among older adults who live in supported senior living settings. This two-arm, parallel RCT included 351 participants aged 55-102 years who resided in assisted and independent settings in 31 senior living communities. Participants were randomized within sites to computerized SOPT vs. computerized crossword puzzles with a targeted dose of 10 hours of playtime at baseline plus 4 hours of booster training at five and eleven months. Depression outcomes included the 9-item Patient Health Questionnaire [PHQ-9] scores, categorical levels, and dichotomous indicators. Random effects linear mixed effect models estimated SOPT effects in intention-to-treat complete case and multiple imputation analyses. Mean age of the sample was 81.0 years, 72.2% were women, and 41.0% resided in assisted living. At baseline 65.7% had no depression [PHQ-9 scores 3 [p = 0.016] and major depressive syndrome [p = 0.045] among the assisted living SOPT group. No significant change in depression was observed in the independent living SOPT or attention control groups. In summary, the SOPT known as Road Tour/Double Decision significantly increased, rather than decreased, the burden of depressive symptoms among participants residing in assisted living. Given these risks, this SOPT program should be avoided among older people in assisted living settings, and other SOPT interventions should be combined with systematic depression monitoring.
Taming the Fairy Tale: Performing Affective Medievalism in Fantasyland

Within Disneyland—a space which already appeals to fantasy and imagination—Fantasyland stands out as simultaneously familiar and exotic, a space created in the recognizable idiom of childhood fairy tales, but one in which those same fairy tales are spaces to be explored as representative of a time and place very different from our own. This chapter argues that Fantasyland reframes medieval European stories in recognizably American idioms, reflecting the influence of the American Dream narrative. Gutierrez-Dennehy argues that Disney’s Fantasyland idealizes economic success, intertwining the company’s medieval ideal with images of middle-class whiteness. Thus, by inserting the values of Middle Class America into the European Middle Ages, Disneyland creates the past in the image of the present. Gutierrez-Dennehy coins the term “affective medievalism” to argue that Disneyland’s use of rigid narrative structures in a space ostensibly meant for visitor exploration works to shut down the pluralism with which the twenty-first century has otherwise characterized the Middle Ages.
Parent perceptions of elementary classroom management systems and their children’s motivational and emotional responses

Classroom management systems emphasizing rewards and consequences have long existed in schools within the US, but parental perceptions of the effects of these systems have largely been ignored. This survey study examined the ways in which 99 parents observed their children responding to various elementary classroom management systems. Regression results showed that behavior chart systems were negatively associated with student autonomous motivation to learn, whereas parent–school relationships and teacher autonomy support were positively associated with autonomous motivation. In hierarchical regression models, the frequency of students receiving rewards was negatively related to parent–school relationships. However, when teacher autonomy support (a strong positive predictor) was added to the model, the effects of reward frequency became non-significant. Parents’ open-ended responses revealed frustrations with systems that caused student anxiety, encouraged dependence on rewards, and oppressed students’ personalities. Implications include consideration of classroom management styles that better promote student autonomous motivation.
The Effect of Esophageal Dysmotility on Lung Transplant Outcomes

Purpose Reflux is a risk factor for chronic lung allograft dysfunction (CLAD), and lung transplant candidates routinely undergo pH and manometry testing. While management of reflux is established, esophageal motility disorders are frequently detected, and their role in the development of CLAD is unclear. This report investigates the effect of esophageal motility disorders on CLAD after lung transplantation. We hypothesized that esophageal dysmotility will result in more frequent development of CLAD. Methods We performed a retrospective review of all patients who underwent lung transplantation between March 2011 and December 2018 (n=71). We excluded patients with fewer than 6 months follow up. Abnormal manometry studies were grouped using the Chicago Classification of esophageal motility v3.0. Serial pulmonary function tests were followed for detection of obstructive CLAD. Results 57 patients met inclusion criteria with a mean follow up of 29.6 months. 29 (50.9%) had abnormal esophageal motility: 3 (10.3%) had esophagogastric junction outlet obstruction (EGJOO), 4 (13.8%) had major peristaltic disorders, and 21 (72.4%) had minor peristaltic disorders. CLAD developed in 25% in patients with normal motility versus 31% in those with abnormal motility (p=0.71). There was no difference in the incidence of CLAD among patients with different motility disorders. No difference in FEV1 improvement was seen between patients with normal motility and peristaltic disorders (p = 0.42). A significant decrease was seen in those with EGJOO when compared to those with normal motility (p=0.01) or peristaltic disorders (p = 0.04). Conclusion Esophageal motility disorders are common in lung transplant candidates. This report suggests that esophageal dysmotility is not associated with development of CLAD. Nevertheless, manometry can detect motility disorders such as EGJOO, which may affect FEV1 recovery after lung transplantation.
ECONOMIC UNCERTAINTY, MONETARY UNCERTAINTY, AND THE DEMAND FOR MONEY IN AFRICA: AN ASYMMETRY ANALYSIS

Economic uncertainty and monetary uncertainty are two uncertainty measures that are said to affect the demand for money in any country and our region of interest, Africa, is no exception. In this p...
Upper Extremity Tendon Transfers: A Brief Review of History, Common Applications, and Technical Tips

Background Tendon transfer in the upper extremity represents a powerful tool in the armamentarium of a reconstructive surgeon in the setting of irreparable nerve injury or the anatomic loss of key portions of the muscle-tendon unit. The concept uses the redundancy/expendability of tendons by utilizing a nonessential tendon to restore the function of a lost or nonfunctional muscle-tendon unit of the upper extremity. This article does not aim to perform a comprehensive review of tendon transfers. Instead it is meant to familiarize the reader with salient historical features, common applications in the upper limb, and provide the reader with some technical tips, which may facilitate a successful tendon transfer. Learning Objectives (1) Familiarize the reader with some aspects of tendon transfer history. (2) Identify principles of tendon transfers. (3) Identify important preoperative considerations. (4) Understand the physiology of the muscle-tendon unit and the Blix curve. (5) Identify strategies for setting tension during a tendon transfer and rehabilitation strategies. Design This study was designed to review the relevant current literature and provide an expert opinion. Conclusions Tendon transfers have evolved from polio to tetraplegia to war and represent an extremely powerful technique to correct neurologic and musculotendinous deficits in a variety of patients affected by trauma, peripheral nerve palsies, cerebral palsy, stroke, and inflammatory arthritis. In the contemporary setting, these very same principles have also been very successfully applied to vascularized composite allotransplantation in the upper limb.
Early transfusion of a large cohort of COVID-19 patients with high titer anti-SARS-CoV-2 spike protein IgG convalescent plasma confirms a signal of significantly decreased mortality

ABSTRACT Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 remains a global threat with few proven efficacious treatments. Transfusion of convalescent plasma collected from donors who have recovered from COVID-19 disease has emerged as a promising therapy and has been granted emergency use authorization by the U.S. Food and Drug Administration (FDA). We recently reported results from interim analysis of a propensity-score matched study suggesting that early treatment of COVID-19 patients with convalescent plasma containing high titer anti-spike protein receptor binding domain (RBD) IgG significantly decreases mortality. We here present results from 60-day follow up of our cohort of 351 transfused hospitalized patients. Prospective determination of ELISA anti-RBD IgG titer facilitated selection and transfusion of the highest titer units available. Retrospective analysis by the Ortho VITROS IgG assay revealed a median signal/cutoff (S/C) ratio of 24.0 for transfused units, a value far exceeding the recently FDA-required cutoff of 12.0 for designation of high titer convalescent plasma. With respect to altering mortality, our analysis identified an optimal window of 44 hours post-hospitalization for transfusing COVID-19 patients with high titer convalescent plasma. In the aggregate, the analysis confirms and extends our previous preliminary finding that transfusion of COVID-19 patients soon after hospitalization with high titer anti-spike protein RBD IgG present in convalescent plasma significantly reduces mortality.
ISOTROPY IN THE TWO-POINT ANGULAR CORRELATION FUNCTION OF THE COSMIC MICROWAVE BACKGROUND

We study the directional dependence of the angular two-point correlation function in maps of the cosmic microwave background (CMB). We propose two new statistics: one which measures the correlation of each point in the sky with a ring of points separated an angle θ away, and a second one that measures the missing angular correlation above 60 deg as a function of direction. Using these statistics, we find that most of the low power in cut-sky maps measured by the Wilkinson Microwave Anisotropy Probe experiment comes from unusually low contributions from the directions of the lobes of the quadrupole and the octupole. These findings may aid a future explanation of why the CMB exhibits low power at large angular scales.
Abstract 16010: Congestive Heart Failure and Coronavirus Disease 2019 Illness Severity

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has killed hundreds of thousands worldwide. Those with cardiovascular disease represent a vulnerable population with higher risk for c...