cssi/SciSciGPT-SciSciNet huggingface dataset:
M/M/1 multiple vacation queueing systems with differentiated vacations

We consider a multiple vacation queueing system in which a vacation following a busy period has a different distribution from a vacation that is taken without serving at least one customer. For ease of analysis it is assumed that the service times are exponentially distributed and the two vacation types are also exponentially distributed but with different means. The steady-state solution is obtained.
Diderot and the Actor's Machine

On the notorious question of sensibility—whether or not an actor should really “feel” the emotion he expresses—Denis Diderot brought off the best known volte-face in the history of acting theory. An erstwhile champion of inspiration and emotionality in theatrical performance, he came to believe, by the time he wrote the Paradoxe sur le comedien (1773), that an actor should not attempt to experience inwardly the passions he enacts onstage. Considerable speculation and controversy have attended Diderot's late substitution of head for heart as the mainspring of theatrical emotion.
Lung disease and asthma severity in adults with asthma : Data from the third national health and nutrition examination

Risk factors for obstructive or restrictive lung disease among persons with asthma are not well defined. Data from the Third National Health and Nutrition Examination Survey were used to determine predictors of poor lung function among 1063 adults, aged 20 years and older, who self-report physician-diagnosed asthma any time during their life regardless of current asthma status. Obstructive lung disease and restrictive lung disease were defined by using spirometry and modified Global Initiative for Chronic Obstructive Lung Disease criteria. Reported symptoms were used to grade asthma severity. Logistic regression models were used to examine associations between lung disease, respiratory symptom severity, and adults who ever had asthma. Risk factors for spirometry-defined obstructive lung disease included increasing age, body mass index < 18.5, current asthma, and non-white race (p < 0.05). Risk factors for spirometry-defined restrictive lung disease included older age at asthma diagnosis, low socioeconomic...
Management of chronic tibial subluxation in the multiple-ligament injured knee.

Management of chronic tibial subluxation requires meticulous preoperative evaluation and planning to maximize patient satisfaction and postoperative outcomes. Knowledge of both knee ligamentous and osseous anatomy and their role in determining knee biomechanics is important to an anatomic reconstruction. This understanding is particularly crucial in the setting of chronic tibial subluxation in the multiligamentous knee injury as an absence of the normal anatomic landmarks and ligamentous restraints may exist. To complete an optimal reconstruction in this setting, the surgeon must establish a careful balance between knee stability and range of motion. In order to achieve this balance, three sequential operative steps should be followed: First, excise all scar tissue to ensure uninhibited knee range of motion; second, reconstruct the ACL and PCL to establish a central knee axis of motion; and third, following possible reconstruction of the medial and lateral complexes, carefully maintain postoperative stability and range of motion with a functional knee brace of external hinge fixator. Close clinical and radiographic follow-up will aid to achieve an optimal postoperative result in this complex clinical situation.
Efficient VLSI architecture for video transcoding

In this paper, we present a unified architecture that can perform Discrete Cosine Transform (DCT), Inverse Discrete Cosine Transform (IDCT), DCT domain motion estimation and compensation (DCT-ME/MC). Our proposed architecture is a Wavefront Array-based Processor with a highly modular structure consisting of 8times8 Processing Elements (PEs). By utilizing statistical properties and arithmetic operations, it can be used as a high performance hardware accelerator for video transcoding applications. We show how different core algorithms can be mapped onto the same hardware fabric and can be executed through the pre-defined PEs. In addition to the simplified design process of the proposed architecture and savings of the hardware resources, we also demonstrate that high throughput rate can be achieved for IDCT and DCT-MC by fully utilizing the sparseness property of DCT coefficient matrix.
Metnase mediates resistance to topoisomerase II inhibitors in breast cancer cells

DNA replication produces tangled, or catenated, chromatids, that must be decatenated prior to mitosis or catastrophic genomic damage will occur. Topoisomerase IIalpha (Topo IIalpha) is the primary decatenating enzyme. Cells monitor catenation status and activate decatenation checkpoints when decatenation is incomplete, which occurs when Topo IIalpha is inhibited by chemotherapy agents such as the anthracyclines and epididophyllotoxins. We recently demonstrated that the DNA repair component Metnase (also called SETMAR) enhances Topo IIalpha-mediated decatenation, and hypothesized that Metnase could mediate resistance to Topo IIalpha inhibitors. Here we show that Metnase interacts with Topo IIalpha in breast cancer cells, and that reducing Metnase expression significantly increases metaphase decatenation checkpoint arrest. Repression of Metnase sensitizes breast cancer cells to Topo IIalpha inhibitors, and directly blocks the inhibitory effect of the anthracycline adriamycin on Topo IIalpha-mediated decatenation in vitro. Thus, Metnase may mediate resistance to Topo IIalpha inhibitors, and could be a biomarker for clinical sensitivity to anthracyclines. Metnase could also become an important target for combination chemotherapy with current Topo IIalpha inhibitors, specifically in anthracycline-resistant breast cancer.
Closing the Gaps in Arc Flash Hazard Mitigation A Review of US, Canada, and EU Standards

Electrical safety is highly regulated in all industrialized countries. Historically, the details of electrical hazard mitigation focused on measures to prevent electric shock. As awareness of arc flash as a unique hazard separate and distinct from shock emerged in the 1980s, standards began to address its mitigation. Comparing standards from North America and the European Union, there are both commonality and differences. This paper benchmarks recognized occupational electrical safety standards against the comprehensive hazard control measures in safety management systems standards. This analysis shows that current electrical safety standards do not provide a comprehensive solution, and that an effective arc hazard mitigation program depends on the integration of several standards.
Promise and Peril of Clinical Decision Support Translating Medical Evidence to the Individual Patient

> “Prediction is very hard, especially about the future.” > > – Niels Bohr The amount of clinical research available to clinicians today has never been more extensive or complex. By one estimation, almost 2100 scientific publications, 75 clinical trials, and 11 systematic reviews are generated daily.1 This explosion in information greatly exceeds a clinician’s cognitive ability to integrate the full body of literature when considering a specific clinical situation or patient. Accordingly, clinical decision support, defined as a system that integrates patient information with a computerized database of clinical research and guidelines, is one of the more exciting potential applications of electronic health records to clinical medicine.2 However, the potential of clinical decision support is not without peril. Article see p 27 Clinical decision support relies on the fundamental assumption that medical evidence can be precisely translated to the individual patient. This translation is not as simple as it may initially appear. Clinical trial results are reported as the average effect of a therapy among the trial population, but these aggregated results rarely correspond to an individual’s response to the therapy.3 Patient characteristics can significantly exaggerate or attenuate its impact. For example, a therapy that reduces myocardial infarction by 10% would have significantly greater effects in a patient whose baseline risk for myocardial infarction was 20% compared with a patient whose risk was only 1%. In addition, therapy effects often occur in a skewed distribution, where a relatively small number of patients derive a significant benefit, whereas most experience little or no effect. Thus, the mean measure of effect in the population fails to describe a typical patient’s expected response to the therapy. Finally, because most therapies usually entail at …
A Coupled-Map Lattice for Simulating Waves in Excitable Media

A simple map which models the kinetics of an excitable chemical reaction is presented. A two-dimensional square lattice of these maps with nearest-neighbor diffusive coupling is iterated on a computer. Spiral waves are obtained similar to those seen in experiment. In particular, the tip of the spiral waves in the simulation exhibits compound rotations.
Inter-Rater Agreement in the Assessment of Video Recordings of Eye Drop Instillation by Glaucoma Patients

Purpose To create a standardized method for evaluating the video recordings of patients self-instilling eye drops and to determine the level of agreement of eye drop instillation efficacy, safety and efficiency ratings by three masked graders. Design Prospective cross-sectional study. Participants 78 patients with open-angle glaucoma or ocular hypertension who had at least 6 months of experience with the use of eye drop medications. Methods Participants were video recorded while self-instilling artificial tears sequentially to both eyes. Three masked observers graded these video recordings on three criteria: efficacy (the determination of whether an eye drop was instilled on the ocular surface), safety (assessment of whether the tip of the medication bottle made contact with the ocular surface or eyelids), and efficiency (the number of eye drops expressed from the bottle). Main Outcome Measures After grading the video recordings based on efficacy, safety, and efficiency, kappa statistics were used to estimate inter-rater agreement. Results The mean kappa level of agreement for efficacy, safety, and efficiency was 0.64 (95% confidence interval (CI), 0.42–0.87), 0.73 (95% CI, 0.58–0.88), and 0.62 (95% CI, 0.42–0.81), respectively. Conclusions We demonstrated good inter-rater reproducibility of the masked analysis of video recordings of patients self-instilling eye drops based on three criteria: efficiency, safety, and efficacy.
Strong Near-Field Coupling of Plasmonic Resonators Embedded in Si Nanowires

The strength of localized surface plasmon resonance (LSPR) near-field interactions scales in a well-known, nearly universal manner. Here, we show that embedding resonators in an anisotropic dielectric with a large permittivity can substantially increase coupling strength. We experimentally demonstrate this effect with Si nanowires containing two phosphorus-doped segments. The near-field decay length scaling factor is extracted from in situ infrared spectral response measurements using the “plasmon ruler” equation and found to be ca. 4−5 times larger than for the same resonators in isotropic vacuum or Si. Discrete dipole approximation calculations support the observed coupling behavior for nanowires and show how it is affected by the resonator geometry, carrier density, and embedding material (Si, Ge, GaAs, etc.). Our findings demonstrate that equivalent near-field interactions are achievable with a smaller total volume and/or at increased resonator spacing, offering new opportunities to engineer plasmon-b...
Growth of Epitaxial LaVO3/(Pb,La)(Zr,Ti)O3/(La,Sr)CoO3 Heterostructures

Epitaxial semiconductor-ferroelectric-conductor LaVO3/(Pb,La)(Zr,Ti)O3/(La,Sr)CoO3 heterostructures were grown on (001) LaAlO3 single crystal substrates by pulsed laser deposition. A high degree of c-axis orientation and strong in-plane texture revealed by x-ray diffraction indicated the epitaxial crystallographic relationships between the layers. The capacitance measurement as a function of voltage revealed the modulation of the depletion layer in the semiconducting LaVO3 as well as the non-linear response of the (Pb,La)(Zr,Ti)O3 ferroelectric layer.
Membrane-bound acetylcholinesterase: comparison of enzymes in sarcoplasmic reticulum and sarcolemma from striated muscle.

Membrane fractions of sarcolemma and sarcoplasmic reticulum prepared from rat diaphragm contain membrane-bound acetylcholinesterase and butyrylcholinesterase. The specific activity of sarcoplasmic reticulum acetylcholinesterase is 4-fold greater than that of sarcolemma, while their butyrylcholinesterase activities are comparable. The innervated portion of the sarcolemma shows enrichment of acetylcholinesterase, whil the noninnervated portion shows enriched butyrylcholinsterase activity. Treatment of membranes with solubilizing agents gave selective solubilization of sarcolemma acetylcholinesterase by collagenase or by 0.5% Triton X-100 in 1 M NaCl, and of sarcoplasmic reticulum acetylcholinesterase by EDTA. Solubilization extracted 70% of the total membrane acetylcholinesterase, with a 2-6-fold increase in specific activity. Membrane-bound acetylcholinesterases were iinhibited by Ca2+, Mg2+ and NaCl. Inhibition by Mg2+ was dependent on the substrate concentration and occurred in both sarcolemma and sarcoplasmic reticulum at substrate concentrations below 0.5 mM. Membrane acetylcholinestrase was activated by Mg2+ only in sarcolemma membranes when the substrate was above 0.7 mM. The properties of membrane-bound acetylcholinesterase are different from those of the soluble enzyme and also vary with respect to membrane type.
Purification of the Digestion Solution of Zinc Oxide Ores

Zn SO4 solution was used as a rawmaterial,which was obtained from zinc oxide ores roasted using( NH4)2SO4and then digested in water. The main components in solution were Zn SO4,Fe2( SO4)3,Al2( SO4)3and so on. NH4HCO3 was used as purifier reagent. Aiming to obtain refined Zn SO4 solution, the ammonium jarosite method and hydrolysis method were adopted to eliminate Fe3 +and Al3 +from the solution. The influences of p H values,the reaction temperature and time on the iron removal rate were discussed,and after the removal of iron,the ammonium jarosite slags were obtained. The p H value of solution was adjusted to precipitate Al3 +and Al( OH)3was yielded out. The XRD,SEMand chemical components analysis were used to characterize the ammonium jarosite and Al( OH)3slags. The results showed that the ammonium jarosite particles with regular shape growes well,and the size of Al( OH)3slags is heterogeneous.
Clinical Study on Transdermal Delivery of Chinese Herbal Medicines for Treating Pain

Objective To observe the clinical effect of transdermal delivery of Chinese herbal medicines in treating pain.Methods A total of 1 621 patients with pain,including 1 080 cases of closed soft tissue injury in the sternocostal part,181 cases of back muscle fasciitis,and 360 cases of scapulohumeral periarthritis,were selected,and the patients with each disease were divided into treatment group and control group.The patients in the treatment groups were treated by spraying ethanol extract liquid of the Chinese herbal medicines with functions of dispelling wind and cold,promoting blood circulation and removing obstruction in collaterals,and reducing inflammation and relieving pain.The patients in the control groups received conventional treatment.The pain of each patient was measured using a pain scale before and after treatment.The two groups of each disease were compared with respect to the time of pain relief and clinical effect of treatment.Results For each disease,the time of pain relief and pain score in the treatment group were significantly shorter and lower than those in the control group(P0.01),and the overall response rate in the treatment group was higher than that in the control group(P0.01).Conclusion Transdermal delivery of Chinese herbal medicines with functions of dispelling wind and cold,promoting blood circulation and removing obstruction in collaterals,and reducing inflammation and relieving pain can achieve quick effect,short treatment period,and high curative rate in treatment of pain.
Radical/π-bond addition between o-benzyne and cyclic C5 hydrocarbons.

Recent theoretical investigations of the radical/π-bond addition between single-ring aromatic hydrocarbons highlight the importance of this category of reactions for the formation of PAH intermedia...
A Spatial–Dynamical Framework for Evaluation of Satellite Rainfall Products for Flood Prediction

AbstractRainfall maps that are derived from satellite observations provide hydrologists with an unprecedented opportunity to forecast floods globally. However, the limitations of using these precipitation estimates with respect to producing reliable flood forecasts at multiple scales are not well understood. To address the scientific and practical question of applicability of space-based rainfall products for global flood forecasting, a data evaluation framework is developed that allows tracking the rainfall effects in space and time across scales in the river network. This provides insights on the effects of rainfall product resolution and uncertainty. Obtaining such insights is not possible when the hydrologic evaluation is based on discharge observations from single gauges. The proposed framework also explores the ability of hydrologic model structure to answer questions pertaining to the utility of space-based rainfall observations for flood forecasting. To illustrate the framework, hydrometeorologica...
Oxidation behavior of V5Si3 based materials

Abstract The oxidation of V5Si3Zx (Z = C or B; x = 0, 0.25, or 0.5) was studied from 600 to 1200 °C. At 600 °C after 150 h, a 1 μm scale of V2O5 formed on V5Si3 at a rate of approximately 0.002 mg cm−2 h−1. At 800 and 1000 °C, the scale on V5Si3 was a mixture of cristobalite and V2O5 liquid, which yielded poor oxidation resistance (0.1 mg cm−2 h−1 at 800 °C and 0.5 mg cm−2 h−1 at 1000 °C). By 1200 °C, the V2O5 had evaporated leaving a passivating layer of tridymite with a steady state mass gain of 0.008 mg cm−2 h−1. Carbon and boron additions had a significant effect on the oxidation resistance in only two cases. At 800 °C, V5Si3B0.5 formed a passivating scale afforded by a low viscosity borosilicate glass. At 1200 °C, instead of tridymite, V5Si3C0.5 formed a passivating layer of cristobalite, which showed slightly better adherence when cooled to room temperature. Open porosity in the starting materials seemed to play a bigger role in oxidation behavior than the carbon and boron additions. Porous samples had thicker, more cracked scales at 800 and 1000 °C due to the penetration of liquid V2O5 into the open porosity. Also, porous samples oxidized at 1200 °C had poor scale adherence at room temperature due to trapped V2O5 within the scale.
BK virus encephalopathy and sclerosing vasculopathy in a patient with hypohidrotic ectodermal dysplasia and immunodeficiency.

Human BK polyomavirus (BKV) is reactivated under conditions of immunosuppression leading most commonly to nephropathy or cystitis; its tropism for the brain is rare and poorly understood. We present a unique case of BKV-associated encephalopathy in a man with hypohidrotic ectodermal dysplasia and immunodeficiency (HED-ID) due to IKK-gamma (NEMO) mutation, who developed progressive neurological symptoms. Brain biopsy demonstrated polyomavirus infection of gray and white matter, with predominant involvement of cortex and distinct neuronal tropism, in addition to limited demyelination and oligodendroglial inclusions. Immunohistochemistry demonstrated polyoma T-antigen in neurons and glia, but expression of VP1 capsid protein only in glia. PCR analysis on both brain biopsy tissue and cerebrospinal fluid detected high levels of BKV DNA. Sequencing studies further identified novel BKV variant and disclosed unique rearrangements in the noncoding control region of the viral DNA (BKVN NCCR). Neuropathological analysis also demonstrated an unusual form of obliterative fibrosing vasculopathy in the subcortical white matter with abnormal lysosomal accumulations, possibly related to the patient’s underlying ectodermal dysplasia. Our report provides the first neuropathological description of HED-ID due to NEMO mutation, and expands the diversity of neurological presentations of BKV infection in brain, underscoring the importance of its consideration in immunodeficient patients with unexplained encephalopathy. We also document novel BKVN NCCR rearrangements that may be associated with the unique neuronal tropism in this patient.
The Role of New Technologies of Communication and Social Audits in Procurement Monitoring

This chapter presents a study of social organizing and activism around public procurement monitoring using new information technologies in Nigeria. From the perspective of civil society organizations (CSO), factors that impede the proper functioning of public procurement in Nigeria are less attributable to contractors than to problems “internal to purchasing and regulatory institutions.” This finding warns against the danger of overregulation and legal conformism without change in administrative, bureaucratic, and political culture.
The Influence of Position on Leg Movements and Kicks in Older Infants With Spina Bifida.

Purpose:The purpose of this study was to describe the frequency with which infants with lumbar or sacral spina bifida (SB) move their legs or kick when they are 7 months and older while in the supine position, seated in a conventional infant seat (CS), and seated in a specially designed infant seat
School outcomes for homeless children: differences among sheltered, doubled-up, and poor, housed children

ABSTRACTSome definitions of child homelessness include the category of children who are doubled-up with others due to loss of housing or economic hardship, while others do not. Are doubled-up children more like children in shelters or children who are poor but housed? A quasi-experimental comparison group design was used to test empirically for differences in school mobility, school attendance, and reading and mathematics achievement among three groups of sheltered, doubled-up, and poor, housed children, respectively, with each group containing 49 students. Sheltered students were found to have significantly higher levels of school mobility and significantly lower rates of school attendance than students in the other two groups. An elaboration of the continuum of risk model is proposed to differentiate experiences of sheltered and doubled-up students. Recommendations are made for policy responses as well as future research.
Six2creFrs2α knockout mice are a novel model of renal cystogenesis.

Six2cre-mediated deletion of Frs2α (Six2creFrs2αKO), a major fibroblast growth factor receptor (Fgfr) docking protein in mouse nephron progenitors results in perinatal renal hypoplasia; however, postnatal Six2creFrs2αKO kidneys develop cysts. We sought to determine the pathogenesis of Six2creFrs2αKO cyst formation. We performed histological assays, Western blots, and quantitative PCR (qPCR). While embryonic day (E) 18.5 Six2Frs2αKO kidneys were hypoplastic and not cystic, postnatal day (P) 7 mutants had proximal tubular-derived cysts that nearly replaced the renal parenchyma by P21. Mutants had high proximal tubular proliferation rates and interstitial fibrosis, similar to known polycystic kidney disease (PKD) models. Six2creFrs2αKO kidneys also had upregulation of Wnt/βcatenin signaling, macrophage infiltration and chemokine production (e.g. ectopic Ccl2 in non-dilated proximal tubules), and augmented hedgehog signaling, features also seen in other PKD models. We saw increased Gli1 (hedgehog readout) in postnatal Six2creFrs2αKO interstitium and ectopic sonic hedgehog (Shh) in subsets of non-dilated P7 mutant proximal tubules (likely driving the stromal Gli expression). As ectopic tubular Shh and Ccl2 expression is seen after acute kidney injury (AKI), we interrogated another bone fide AKI marker, Kim1 and noted ectopic expression in P7 non-dilated proximal tubules. These observations suggest that aberrantly activated “AKI” pathways may drive pathogenesis in PKD.
591. MiRNAs Regulates PVRL4 and Oncolytic Measles Virus Infectivity in Glioblastoma and Breast Cancer

Oncolytic measles virus strains are currently being evaluated in several clinical trials including glioblastoma and ovarian cancer, while clinical application in breast cancer is in development. The role of poliovirus receptor-related 4 (PVRL4), as a measles virus receptor, has been well documented. However the regulation of PVRL4 is not well understood. Immunohistochemistry and western blot analysis shows increased PVRL4 protein levels in glioblastoma and breast tumor clinical samples with no significant change in PVRL4 mRNA levels detected by qRT-PCR, suggesting that PVRL4 is likely post-transcriptionally regulated. Genes can be post-transcriptionally regulated by miRNAs by binding to the 3’UTR of the targeted mRNA causing translational repression or degradation. Thus, we sought to investigate the potential role of miRNAs in PVRL4 post-transcriptional regulation. Algorithms from microRNA. org and RegRNA, predicted that, from the miRNAs that are reportedly down-regulated in glioblastoma and breast cancer, miR-31 and miR-128 binds the 3’UTR of PVRL4. Indeed, luciferase binding assays demonstrated miR-31 and-128binding to the 3’UTR of PVRL4, suggesting that PVRL4 is a miRNA targeted gene. QRT-PCR studies validated that miR-31 and miR-128 are down-regulated in glioblastoma and breast tumor clinical samples, further supporting the hypothesis that PVRL4 are post-transcriptionally regulated by miRNAs. In order to understand the effects of the respective miRNAs on PVRL4 and thus on measles virus infectivity, a viral strain (Leonard et. al, 2010, J. Virol.) that exclusively utilizes PVRL4 as its receptor was employed to infect the cancer cell lines followed by evaluation of virus infectivity via measles viral nucleoprotein (N-protein) levels. Subsequent gain -and loss-of-function experiments showed that overexpression of miR-31and miR-128, via lentiviral-vector transduction, down-regulated the endogenous levels of PVRL4 and measles virus infectivity, while transduction of lentiviral-vectors expressing PVRL4 restored measles virus infectivity. The functional affects were reversed or increased upon transduction with the complementary anti-miRs-128 and anti-miR-31. These results are being further validated in ongoing in vivo mouse models where cancer cell lines stably transduced with miR-128, miR-31 or anti-miR-128, anti-miR-31, are transplanted in mice to evaluate tumor size and survival rates upon measles virus infection. These data suggest that PVRL4 is post-transcriptionally regulated by miR-128 and miR-31, and thus, these represent possible miRNA targets that could modulate PVRL4 levels in order to enhance oncolytic measles virus infectivity.This research is supported by P50 CA 108961-7, P50 CA 136393-4, P50 CA 116201-7 and R01 CA 136547-4.
Clinical significance of programmed death ligand-1 expression in non-small cell lung cancer (NSCLC).

11075 Background: Programmed cell death ligand-1 (PDL1) is expressed on various human cancers and is a major mechanism for immune evasion. Preliminary evidence suggests that PDL1 expression on cancer cells predicts response to anti-PD-1 therapy. Here we report our findings using automated quantitative immunofluorescence (QIF) to determine the frequency and prognostic value of PDL1 in two independent NSCLC cohorts. Methods: Five antibodies against PDL1 were screened for sensitivity and specificity using PDL1 transfected cells, normal human placenta and tonsil. Only one monoclonal antibody (clone 5H1) met criteria for specificity. This antibody was used to assess two cohorts of NSCLC cases in TMAs. The cohorts represented 204 cases from Yale University and 340 cases from hospitals in Greece. PDL1 protein was measured using QIF analysis using AQUA method. In addition, in-situ PDL1 mRNA levels were measured in the Greek cohort using the RNAscope paired-primer assay with AQUA method. Results: PDL1 protein expr...
Compassion-Based Meditation in African Americans: Self-Criticism Mediates Changes in Depression.

This study examines self-criticism as a mechanism through which compassion meditation reduces depressive symptoms in low-income African American men and women (N = 59) who had recently attempted suicide. After completing several measures, including the Levels of Self-Criticism Scale and Beck Depression Inventory-II, participants were randomly assigned to receive either a six-session compassion meditation (CM) group (Grady Compassion and Meditation Program) or a six-session support group. As predicted, path analysis results showed that treatment condition led to changes in self-criticism from pre- to posttreatment, with those receiving CM showing greater reductions in levels of self-criticism than those randomized to the support group. Path analyses also revealed that changes in self-criticism fully mediated the link between condition and changes in depressive symptoms. These findings highlight the importance and value of targeting levels of self-criticism in compassion-based interventions to reduce the depressive symptoms of suicidal African Americans.
Nonpharmacologic Treatments of Status Epilepticus

When first- and second-line antiseizure drugs fail to stop status epilepticus, morbidity and mortality increase substantially. This chapter reviews adjunctive nonpharmacologic options for treating status epilepticus when standard drugs are ineffective. These treatments include therapeutic hypothermia, neurostimulation (electroconvulsive therapy, vagus nerve stimulation, transcranial magnetic stimulation), ketogenic diet therapies (ketogenic diet, modified Atkins diet, low glycemic index treatment), intracranial procedures (resective surgery, corpus callosotomy, multiple subpial transection), and combination therapies. Evidence for the use of these treatments mostly comprises studies of animal models of status epilepticus, treatments for epilepsia partialis continua in humans, and retrospective case reports and case series in patients treated for refractory and super-refractory status epilepticus. Compared to morbidity and mortality rates reported in the literature with refractory and super-refractory status epilepticus, several of these treatments are promising in both children and adults. Prospective clinical trials are needed to establish the safety, feasibility, and efficacy of these treatments in status epilepticus and to determine the best approach for incorporating them into standard status epilepticus treatment algorithms. Background, potential mechanisms of action, treatment protocols, evidence for efficacy, side effects, and contraindications are described for each treatment modality.
Comparison of 4 commercially available group B Streptococcus molecular assays using remnant rectal-vaginal enrichment broths.

Abstract The incidence of neonatal Group B streptococcal (GBS) disease has significantly declined since the widespread implementation of prenatal screening of expectant mothers for urogenital and gastrointestinal tract GBS colonization. Screening methods have evolved from exclusively culture-based approaches to more rapid and highly sensitive molecular methods. We chose to evaluate the performance of 4 commercially available GBS molecular tests for detection of GBS colonization using 299 antepartum rectal–vaginal specimens submitted to our laboratory for routine GBS screening. In 97% of instances, there was agreement between all 3 systems. When testing 1, 6, and 12 samples simultaneously, all methods performed comparably, but the ARIES® GBS assay required the least total hands-on time and the illumigene® Group B Streptococcus assay required the most hands-on time.
Formal verification of pure production system programs

Reliability, defined as the guarantee that a program satisfies its specifications, is an important aspect of many applications for which rule-based programs are suited. Executing rule-based programs on a series of test cases does not guarantee correct behavior in all possible test cases. To show a program is reliable, it is desirable to construct formal specifications for the program and to prove that it obeys those specifications. This paper presents an assertional approach to the verification of a class of rule-based programs characterized by the absence of conflict resolution. The proof logic needed for verification is already in use by researchers in concurrent programming. The approach involves expressing the program in a language called Swarm, and its specifications as assertions over the Swarm program. Among models that employ rule-based notation, Swarm is the first to have an axiomatic proof logic. A brief review of Swarm and its proof logic is given, along with an illustration of the formal verification method used on a simple rule-based program.
Symbolic Computation of Hypersingular Boundary Integrals

Analytical formulas for evaluating hypersingular boundary integrals can be efficiently generated by symbolic computation programs. The singular integrals can be defined in terms of a ‘limit-to-the-boundary’, and this limit process can be automated by employing the Taylor-Lau rent series expansion capabilities of these programs. As a check on the calculations, the potentially divergent terms which arise in the theory can also be calculated by this method and shown to cancel. The symbolic computation procedure is illustrated for the hypersingular kernels of the two-dimensional elastic wave equation.
Fredholm Integral Equations in Biophysical Data Analysis

In the last decade, the abundant availability of computational resources has allowed for significant improvements in the interpretation of data in traditional disciplines of physical biochemistry. In particular, there are many examples where the data are fitted with a model describing a distribution of parameters, taking the form of a Fredholm integral equation. Algorithms traditionally applied in image analysis have proven highly useful to solve the corresponding ill-posed inverse problem. Two examples are presented from optical biosensing and sedimentation velocity analytical ultracentrifugation. In both examples, standard regularization techniques such as Tikhonov and maximum entropy regularization are applied, in conjunction with non-negativity constraints. Further, Bayesian adaptations of the regularization functional are possible that incorporate available prior knowledge on the system under study. Practical limitations and problems will be discussed.
A Steganographic Approach to Sonar Tracking

Steganographic transmission waveforms are desirable for many applications, such as underwater acoustic communications, surveillance, detection, and tracking. In the context of active sonar tracking, an overall approach is presented that covers several topics including background sound modeling, steganographic security assessment of transmission waveforms, target motion modeling, and batch track detection. In shallow water, environment background sound dominated by snapping shrimp, the presented approach shows feasibility of steganographic sonar for target track detection. A background sound modeling approach is presented that utilizes symbolic time-series analysis with phase space representation and clustering of time-series segments. The time-evolving characteristics are captured with a hidden Markov model. Steganographic security of the transmission waveform can be assessed by measuring the Kullback–Leibler divergence between the cover model and the stego model. Conventional tracking approaches fail to perform reliably and existing track-before-detect approaches also fail due to overwhelming search computation when they use simplistic short timescale motion models. A long timescale target motion model with considerations for plausibility is presented and utilized in a batch track detection approach. A Monte-Carlo-based simulation is performed to find the scenarios that demonstrate the feasibility of steganographic sonar in a shallow water environment with snapping shrimp sound.
Cognitive Therapy of Depression

1. An Overview 2. The Role of Emotions in Cognitive Therapy 3. The Therapeutic Relationship: Application to Cognitive Therapy 4. Structure of the Therapeutic Interview 5. The Initial Interview 6. Session by Session Treatment: A Typical Course of Therapy 7. Application of Behavioral Techniques 8. Cognitive Techniques 9. Focus on Target Symptoms 10. Specific Techniques for the Suicidal Patient 11. Interview with a Depressed Suicidal Patient 12. Depressogenic Assumptions 13. Integration of Homework into Therapy 14. Technical Problems 15. Problems Related to Termination and Relapse 16. Group Cognitive Therapy for Depressed Patients Steven D. Hollon and Brian F. Shaw 17. Cognitive Therapy and Antidepressant Medications 18. Outcome Studies of Cognitive Therapy Appendix: Materials *The Beck Inventory *Scale for Suicide Ideation *Daily Record of Dysfunctional Thoughts *Competency Checklist for Cognitive Therapists *Possible Reasons for Not Doing Self-Help Assignments *Research Protocol for Outcome Study at Center for Cognitive Therapy *Further Materials and Technical Aids
Understanding the Buffering Effects of Protective Factors on the Relationship between Adverse Childhood Experiences and Teen Dating Violence Perpetration

Prior research has demonstrated the scope and impact of adverse childhood experiences (ACEs) on health and wellbeing. Less is known about the trajectories from exposure to ACEs, such as witnessing family conflict and violence in the community, to teen dating violence perpetration, and the protective factors that buffer the association between early exposure to ACEs and later teen dating violence perpetration. Students (n = 1611) completed self-report surveys six times during middle and high school from 2008 to 2013. In early middle school, the sub-sample was 50.2% female and racially/ethnically diverse: 47.7% Black, 36.4% White, 3.4% Hispanic, 1.7% Asian/Pacific Islander, and 10.8% other. Youth were, on average, 12.7 years old. Latent transition analysis was used to assess how trajectories of exposure to parental conflict and community violence during middle school transition into classes of teen dating violence perpetration (e.g., sexual, physical, threatening, relational, and verbal) in high school. Protective factors were then analyzed as moderators of the transition probabilities. Three class trajectories of ACEs during middle school were identified: decreasing family conflict and increasing community violence (n = 103; 6.4%), stable low family conflict and stable low community violence (n = 1027; 63.7%), stable high family conflict and stable high community violence (n = 481; 29.9%). A three class solution for teen dating violence perpetration in high school was found: high all teen dating violence class (n = 113; 7.0%), physical and verbal only teen dating violence class (n = 335; 20.8%), and low all teen dating violence class (n = 1163; 72.2%). Social support, empathy, school belonging and parental monitoring buffered some transitions from ACEs exposure trajectory classes to teen dating violence perpetration classes. Comprehensive prevention strategies that address multiple forms of violence while bolstering protective factors across the social ecology may buffer negative effects of exposure to violence in adolescence.
Pediatric Headache Management and Use of the PedMIDAS

Background Headache is a worldwide problem affecting people of all ages, races, and incomes. Childhood headache is a common condition affecting quality of life and prompting frequent medical visits. The Pediatric Migraine Disability Assessment tool (PedMIDAS) is a validated questionnaire recognized in the assessment of pediatric headache. Use of the PedMIDAS is supported in the 2014 American Academy of Neurology headache quality measurement set, which provides practice parameters for headache management. Objective The purpose of this quality improvement project is to introduce the PedMIDAS into the assessment of pediatric headache patients in a pediatric neurology practice in an attempt to standardize care and discern provider satisfaction. Methods Chart review (11-21-16 to 11-30-17) following provider/staff education regarding the PedMIDAS. Results The PedMIDAS was completed 23% of the time (404/1741). Conclusions Although the PedMIDAS was only completed 23% of the time, providers surveyed regarding usefulness indicated the PedMIDAS is helpful with quantifying the disability experienced by pediatric headache patients. Implications for nursing Assessing disability through the use of the PedMIDAS is a beneficial practice change helping with evaluating headache interventions, differentiating headache frequency from disability, and clarifying the severity of pain related to headache that affects daily life.
Stigma in Class: Mental Illness, Social Status, and Tokenism in Elite College Culture:

The majority of mental illness on college campuses remains untreated, and mental illness stigma is the most common reason for not seeking mental health treatment. Compared with affluent students, w...
Missed opportunities for prevention and treatment of hepatitis C among persons with HIV/HCV coinfection.

Hepatitis C (HCV) and HIV have common modes of transmission but information about HCV transmission risk, prevention, and treatment among persons with coinfection is lacking. The Medical Monitoring ...
A Framework for Race-Related Trauma in the Public Education System and Implications on Health for Black Youth.

Background A combination of increased suicide in the past decade, documented high rates of anxiety and depression, and the preponderance of other behavioral and emotional regulation challenges place black youth at risk for school suspension and involvement in the juvenile justice system. Pointing to deficits in black youth and their families negates how forces of racism, whether unconscious or conscious, can disrupt well-being. Methods A framework for race-related trauma in the public education system illustrates the interplay between macro-level forces, such as institutional and symbolic racism, and micro level forces of racism such as racial discrimination and violence. Identifying causal links between these forces and adverse academic and health outcomes for black youth can inform interventions and strategies to reduce race-related trauma. Results The framework for race-related trauma is a multi-level analysis of racism and recognizes school districts facing economic restraints and school personnel turnover may face significant challenges in designing intervening strategies. Conclusion The framework guides change effort towards improving school climate and culture through preparing school professionals to meet the diverse needs of youth, strengthening family and community collaboration, and tackling those policies and behaviors that exclude and disconnect black youth.
Effect of EKG Sampling Rate on Heart Rate Variability Analysis

We studied the effect of EKG sampling rate on heart rate variability (HRV) analysis. We acquired EKG from four term hypoxic-ischemic encephalopathic infants undergoing therapeutic hypothermia. The EKG signal was acquired continuously for 4 days from the cardiorespiratory monitor through the analog port. The following HRV metrics were calculated: normalized low-frequency (nLF), normalized high-frequency (nHF), low-frequency (LF), high-frequency (HF), short-term detrended fluctuation analysis (DFA) exponent (α s ), long-term DFA exponent (α L ), root mean square (RMS) short (RMSS), and RMS long (RMSL). In addition, heart rate was used. These metrics were calculated for EKG acquired at 1 KHz (served as reference, EKGref) as well as from EKGs downsampled at 500 Hz (EKG 500 ), 250 Hz (EKG 250 ), and 125 Hz (EKG 125 ). The bedside monitors were simultaneously sending the EKG to a data warehouse, storing the EKG (EKG DWH ) at 250 Hz. All HRV metrics were also calculated for the EKG DWH . The comparison between HRV metrics calculated from EKG ref and downsampled EKG (EKG 500 , EKG 250 , EKG 125 ) was made with intraclass correlation coefficient (r). The comparisons of HRV metrics between EKG 250 and EKG DWH were also made with ICC. Our results show that HRV calculated with EKG ref and from downsampled EKG were highly correlated (r>0.8 for all comparisons, P 250 and EKG DWH were also significantly correlated (r=0.7, P DWH signal and caution must be exercised in interpreting the HF power calculated from this EKG.
Breast Reconstruction Does Not Increase the Incidence of Postmastectomy Pain Syndrome: Results of a Meta-Analysis.

Background Postmastectomy pain syndrome (PMPS) is characterized by neuropathic pain from direct nerve injury during oncologic breast surgery causing chronic pain, often leading to chronic opioid dependence and long-term disability. To our knowledge, this study represents the first meta-analysis that defines the incidence of PMPS in patients undergoing mastectomy, with and without breast reconstruction. Methods The Cochrane, Embase, MEDLINE, and PubMed databases were queried. A total of 166 citations from 1991 to 2017 were reviewed to identify 22 unique manuscripts. Inclusion criteria required: (i) minimum 3-month follow-up, (ii) pain in breast, (iii) pain after mastectomy, (iv) documentation of any reconstruction, and (v) minimum of level three evidence. Comprehensive Meta- Analysis Software and Microsoft Excel were used for statistical calculations. Results Sixteen manuscripts described the prevalence of postmastectomy pain and 11 described the prevalence of postreconstruction pain (5 had data for both). Study population size ranged from 32 to 1165 patients. All studies were classified as level 2 or level 3 evidence. The mean prevalence of pain after mastectomy alone using a random-effects model is 35.6% (30.3%-41.3%). Mean prevalence of pain after mastectomy with reconstruction using the random-effects model is 32.8% (24.4% - 42.5%). Analysis of variance analysis showed no significant difference between prevalence of chronic pain after mastectomy alone versus mastectomy and reconstruction (P = 0.88). Conclusions Our meta-analysis establishes that postmastectomy reconstruction does not increase the incidence of PMPS. However, because this neuropathic pain often persists after reconstructive surgery, it is incumbent on the plastic surgeon to counsel patients on PMPS. Moving forward, prospective studies on the effects of reconstruction type and adjunct procedures are warranted.
Wireless Communication Between FPGA and Microcontroller

This paper offers a new method to the design and implementation of wireless communication between an FPGA device and a microcontroller. Wireless Bluetooth communication is utilized, as the Bluetooth modules are low-cost compared to other wireless modules and provide easy interfacing with both the FPGA and microcontroller. FPGAs have a higher parallel processing ability and can accomplish very precisely timed continuous and simultaneous tasks. This is done using UART protocol, as a means to exchange the data. With these predominate abilities, FPGAs can be crafted into a central unit for processing. By using the FPGA to take on some of the processing tasks, it improves system performance and frees up the MCU from cycle-intensive tasks. In this display of wireless communication, the microcontroller and sensors are mounted remotely. Communication between the microcontroller and FPGA is attained through Bluetooth, that operates in the 2.4 GHz frequency. UART protocol is utilized for interfacing the Bluetooth module with both the microcontroller and FPGA. As FPGAs do not have any dedicated logic to communicate with microcontrollers, a UART module was designed and implemented with an FPGA using a state machine design. The paper discusses several ways for these implementations.