cssi/SciSciGPT-SciSciNet huggingface dataset:
Field and Electroantennogram Responses to Sex Pheromone Optical Isomers by Four Fall-Flying Sawfly Species (Hymenoptera: Diprionidae, Neodiprion )

Optical isomers of pine sawfly sex pheromones, the acetate and propionate esters of 3,7-dimethylpentadecan-2-ol, were tested in the field and by electroantennograms (EAGs) for activity toward four species or species complexes of fall-flying Neodiprion sawflies (Hymenoptera: Diprionidae): Neodiprion pratti complex, Neodiprion taedae linearis Ross, Neodiprion nanulus nanulus Schedl, and Neodiprion sertifer (Geoffroy). Traps baited with the acetate of the 2S, 3S, 7S isomer caught males in all cases. The propionate form of this isomer was active in all cases except Neodiprion pratti pratti . N. p. pratti were caught in traps baited with the propionate of the 2S, 3R, 7R isomer. The 2S, 3R, 7R propionate isomer elicited the greatest EAG response from N. p. pratti antennae, whereas the 2S, 3S, 7S acetate isomer was most active with the other species.
Introduction, to ‘Competition Policy in Health Care in an Era of Reform’

Health care reform recently has been signed into law by President Obama. The signing concluded a tortuous legislative process involving false starts, recriminations, accusations of stonewalling on one side and “ramming” using “dirty tricks” on the other, threats of filibuster, and fear of electoral response. Passage of health care reform legislation is just the beginning. As with all major legislation, there will be many years of learning what the new law means in application. And the absorption process for the second-order regulatory scheme of antitrust will be even slower. I introduce here the transcript of a panel discussion, held on December 10, 2009, which I believe to be the first broad (if not comprehensive) analysis of the competition policy implications of health care reform. The pages following this introduction provide a road map for correctly analyzing many of the antitrust issues that have arisen in health care previously and are certain to arise in health care as reformed. Understanding how to analyze these issues could not be more important. As panelist Paul London wrote in 2001, “[r]eal competition in health care would stimulate the American economy.” London noted the competition picture raised questions about insurance, providers – doctors and hospitals, technologies and information systems, and regulatory approaches. To this end we convened a rare gathering of think-tankers, academic economists, law, business and medical school professors, and practitioners, all with deep expertise in the arenas of health law, antitrust law, and in many cases, both. Several of our participants came originally from the world of government antitrust enforcement. We gathered for an entire day, initially for several hours in a private think-tank style discussion, and later in a public panel discussion. During both sessions, topic leaders introduced a particular genus of issues on which they previously had submitted written work to the group. The topic leaders then described some possible resolutions to those issues, and the group engaged in the discussion. In the afternoon session, the transcript of which follows, we reprised some of the same discussion, but our public discussion was neatly distilled by the morning's conversation. This is my introduction to the topic, with a transcript of the panel discussion following.
Water and urea permeability properties of Xenopus oocytes: expression of mRNA from toad urinary bladder

The Xenopus oocyte was evaluated as an mRNA expression system for water and urea transporters. Osmotic water permeability (Pf) was measured from the time course of oocyte volume in response to osmo...
The -Omics Race

A number of advancements concerning the genome organization and functioning of the bacterial chromosome are reviewed, including the genome GC content, gene ordering and classification, and the biological role of operons. Some bioinformatic resources available for genome analysis are briefly shown. Processes related to regulation and gene silencing are also described. Recombination and the evolution, among invertebrate-associated bacteria, of reduced genomes are also discussed. Applications of metagenomic approaches to soil and invertebrate studies are reviewed, together with some aspects of metatranscriptomics and proteomics.
Batteries and a Sustainable Modern Society

After outlining the urgent need for realization of clean electrical energy generated by the sun for a sustainable modern society and the constraints of electrochemistry for this realization in a low-cost, safe rechargeable battery of long cycle life, recent advances in materials chemistry are outlined that provide an optimistic view that this realization may be possible in the relatively near future.
Characteristics and variations of in vivo Schlemm's canal and collector channel microstructures in enhanced-depth imaging optical coherence tomography

Background/aims To characterise in vivo Schlemm9s canal (SC) and collector channels (CC) microstructures using enhanced-depth imaging (EDI) optical coherence tomography (OCT). Methods Serial horizontal EDI OCT B-scans (81 scans, 15×5° rectangle) were prospectively obtained in the nasal and temporal limbus. SC cross-sectional area (CSA) was measured by delineating its lumen in each B-scan. CCs connected to SC were counted. SC CSA and the number of CCs were compared between the nasal and temporal areas. Results Eleven eyes (11 normal subjects) were included (mean age, 28±5 years). SC and CCs were clearly demarcated in EDI OCT B-scans with excellent repeatability and reproducibility (intraclass correlation coefficients, 0.830–0.886 and 0.793, respectively; all p 2 (average, 3514±1235 µm 2 ), and among different regions of the same eye with coefficient of variation in each eye ranging from 23% to 46% (average, 32±7%). The number of CCs in the analysed area also varied considerably among subjects, ranging from 5 to 11 (average, 8.73±1.85). The mean SC CSA (3839±1402 µm 2 vs 3189±1209 µm 2 ; p=0.033) and number of CCs (5.5±1.4 vs 3.3±1.1; p=0.001) were significantly greater nasally than temporally. The mean SC CSA was significantly correlated with the number of CCs (r=0.635, p=0.036). Conclusions High-quality images of the aqueous outflow pathway can be obtained with a clinical device, avoiding postacquisition processing. In vivo SC and CC microstructures vary considerably among individuals and regions. SC tends to be larger in regions with more CCs.
Differences in psychiatric symptoms and barriers to mental health care between volunteer and career firefighters

Firefighters are at increased risk for mental health problems. However, little is known about differences in psychiatric symptoms between volunteer and career firefighters. This study aimed to (1) describe differences in psychiatric symptoms and barriers to mental health care between U.S. firefighters in volunteer-only and career-only departments; and (2) determine if greater self-reported structural barriers to mental health care (e.g., cost, availability of resources) explain the differences in psychiatric symptom levels. Overall, 525 current U.S. firefighters participated. Analyses of covariance and logistic regression analyses were used to evaluate group differences between volunteer (n=204) and career (n=321) firefighters, adjusting for demographic and occupational characteristics. Volunteer firefighters reported significantly elevated levels of depression, posttraumatic stress, and suicidal symptoms compared to career firefighters. Career firefighters reported relatively elevated levels of problematic alcohol use. Volunteer firefighters additionally reported greater structural barriers to mental health care (e.g., cost, availability of resources), and these barriers accounted for the differences in mental health variables between volunteer and career firefighters. Findings suggest that volunteer firefighters report elevated psychiatric symptoms compared to career firefighters and greater structural barriers to mental health treatment may explain this link. Increased efforts are needed to develop firefighter-specific interventions and bolster mental health service utilization.
Shaping the future of education with empathic companions

With the advances in computing technologies, we have been undergoing a shift towards a digital world. As an inevitable result of this shift, the technology penetrates into education in myriad forms. Intelligent tutoring systems (ITS) are essential outcomes of this penetration, emerging to satisfy the needs of learners and instructors. Their working principle is based on collecting and processing data of all students through various modalities to understand the strengths and needs of learners. Yet, more important is that ITSs untangle the overlooked problem of traditional education: One size does not fit all, and there is a need for personalized tutoring for each individual. It is well known that that learning is emotional as well as intellectual. To truly meet the needs of education, we need empathic companions, ones that are affectively aware and thus can accompany the learner for an enhanced learning experience.
Treatment of stage I non-small cell lung cancer: What's trending?

Abstract Objectives Stage I non–small cell lung cancer traditionally is treated with lobectomy. Sublobar resection and stereotactic body radiation therapy provide alternative treatments for higher-risk groups. The purpose of this study was to determine the national treatment trends for stage I lung cancer. Methods The National Cancer Database was queried for patients with clinical stage I non–small cell lung cancer between 1998 and 2012. Patients were compared across treatment groups, and trends in treatment and disease were evaluated over the 15-year time period. Results The National Cancer Database contained 369,931 patients with clinical stage I non–small cell lung cancer. After removing patients who received chemotherapy as a first course of treatment and patients with pathologic stage IV, 357,490 patients were analyzed. The first recorded cases of stereotactic body radiation therapy are in 2003 and rapidly increased to 6.6% (2063) of all patients treated in 2012. The number of diagnoses of stage I non–small cell lung cancer steadily increased over the 15-year period, whereas the rate of lobectomy decreased from 55% in 1998 to 50% in 2012 ( P P P = .283). Conclusions Although the number of stage I non–small cell lung cancer cases continues to increase, lobectomy rates are decreasing while sublobar resection and stereotactic body radiation therapy rates are increasing. Although the increasing popularity of alternative therapies to lobectomy for treatment of stage I non–small cell lung cancer should allow more patients to undergo treatment, we did not observe this trend in the data.
Oscillatory coalescence of droplets in an alternating electric field

Experiments show that a pair of droplets in an alternating electric field coalesce through a repeated sequence: dipole-dipole attraction, the formation of liquid bridge, the repulsion of equipotential droplets, the elongation and breakup of the bridge.
How does the tumor microenvironment play a role in hepatobiliary tumors

The tumor microenvironment (TME) is defined as the structural and dynamic network of cellular and non-cellular interactions between malignant cells and the surrounding non-malignant matrix. Hepatocellular carcinoma (HCC) and pancreatic ductal adenocarcinoma (PDAC) are two of the most challenging gastrointestinal malignancies. Despite clinical advancements in understanding tumor biology and growth of the chemotherapeutic industry, there have been no corresponding improvements in prognosis and overall survival of HCC and PDAC. Both of these cancers have a very intimate relationship with their surrounding environment; the TME is thought to actively participate in initiating and sustaining these malignancies. Individual TME constituents play a vital role in chemoresistance and recurrence after surgery and have been established as independent prognostic factors. This review article will highlight the diverse structural components, key signaling pathways, and extracellular matrices of HCC and PDAC and discuss their crosstalk with tumor cells to promote growth and metastasis. The article will also summarize the latest laboratory and clinical research based on therapeutic targets identified within the TME of both HCC and PDAC.
Disjointed Cosmopolitanism: Climate Change and Lived Experience in Portland, Oregon

Climate change has emerged as one of the most significant issues facing the world. This research endeavored to uncover and describe the lived experience of Portland, Oregon residents in relation to the substantive issue of climate change. The specific purpose of this research was to gain a better understanding of the ways that Portland residents conceive of and communicate about climate change. Utilizing semistructured phenomenological interviews, particular attention was paid to the culture of Portland residents, their lived experience and how the issue of climate change manifests itself in their everyday experiences. In addition, this particular phenomenological inquiry incorporated elements of auto ethnography by positioning the researcher’s experiences, imagination and intellect at the center of the research endeavor. Multiple themes emerged from the in-depth, descriptive interviews that helped to reveal the structure or essence of the participant’s experience(s). A single meta-theme was identified and informed by contemporary theories such as Cosmopolitanism and the Environmental Justice
A characterization of performance by men and women in a virtual Morris water task:: A large and reliable sex difference

In many mammalian species, it is known that males and females differ in place learning ability. The performance by men and women is commonly reported to also differ, despite a large amount of variability and ambiguity in measuring spatial abilities. In the non-human literature, the gold standard for measuring place learning ability in mammals is the Morris water task. This task requires subjects to use the spatial arrangement of cues outside of a circular pool to swim to a hidden goal platform located in a fixed location. We used a computerized version of the Morris water task to assess whether this task will generalize into the human domain and to examine whether sex differences exist in this domain of topographical learning and memory. Across three separate experiments, varying in attempts to maximize spatial performance, we consistently found males navigate to the hidden platform better than females across a variety of measures. The effect sizes of these differences are some of the largest ever reported and are robust and replicable across experiments. These results are the first to demonstrate the effectiveness and utility of the virtual Morris water task for humans and show a robust sex difference in virtual place learning.
Autophagy and inflammation: A special review issue

Macroautophagy/autophagy is a fundamental intracellular homeostatic process that is of interest both for its basic biology and for its effect on human physiology in a wide spectrum of conditions and diseases. Autophagy was first appreciated primarily as a metabolic and cytoplasmic quality control process, but in the past decade its role in immunity has been steadily growing. The connections between these aspects beckon explorations of the network and connections that exist between metabolism, quality control, and inflammation and immunity processes, which are so key to many human diseases including neurodegeneration, obesity and diabetes, chronic inflammatory conditions, cancer, infection, and aging. The purpose of this issue is to stimulate further the burgeoning studies of the intersections between autophagy and inflammation, and the inevitable overlaps with metabolic and quality control functions of autophagy.
Pulsed magnetic field generation suited for low-field unilateral nuclear magnetic resonance systems

Pulsed magnetic fields can be used to provide instantaneous localized magnetic field variations. In presence of static fields, pulsed field variations are often used to apply torques and in-effect to measure behavior of magnetic moments in different states. In this work, the design and experimental performance of a pulsed magnetic field generator suited for low static field nuclear magnetic resonance (NMR) applications is presented. One of the challenges of low bias field NMR measurements is low signal to noise ratio due to the comparable nature of the bias field and the pulsed field. Therefore, a circuit is designed to apply pulsed currents through an inductive load, leading to generation of pulsed magnetic fields which can temporarily overpower the effect of the bias field on magnetic moments. The designed circuit will be tuned to operate at the precession frequency of 1H (protons) placed in a bias field produced by permanent magnets. The designed circuit parameters may be tuned to operate under different bias conditions. Therefore, low field NMR measurements can be performed for different bias fields. Circuit simulations were used to determine design parameters, corresponding experimental measurements will be presented in this work.Pulsed magnetic fields can be used to provide instantaneous localized magnetic field variations. In presence of static fields, pulsed field variations are often used to apply torques and in-effect to measure behavior of magnetic moments in different states. In this work, the design and experimental performance of a pulsed magnetic field generator suited for low static field nuclear magnetic resonance (NMR) applications is presented. One of the challenges of low bias field NMR measurements is low signal to noise ratio due to the comparable nature of the bias field and the pulsed field. Therefore, a circuit is designed to apply pulsed currents through an inductive load, leading to generation of pulsed magnetic fields which can temporarily overpower the effect of the bias field on magnetic moments. The designed circuit will be tuned to operate at the precession frequency of 1H (protons) placed in a bias field produced by permanent magnets. The designed circuit parameters may be tuned to operate under differe...
A numerical hybrid model for outdoor sound propagation in complex urban environments

Noise mapping in large and dense urban areas is computationally challenging, if not impossible, with the use of conventional numerical techniques. Recently, promising results have shown the potential of energy-based models to compete with conventional numerical techniques. In this paper, a hybrid full-wave/diffusion propagation model is proposed to address some of the flaws of the traditional diffusion model. The full-wave model is used for predicting sound propagation (i) near the source, where interactions between waves are important, and (ii) outside the cluttered environment, where free-field-like conditions apply. The diffusion model is used in regions where diffusion conditions are met.
A comparison of the effectiveness of rosuvastatin, atorvastatin and simvastatin in achieving target lipid levels (according to the PROFILE-I registry)

The aim of the study: was to evaluate the effectiveness of lipid-lowering therapy, depending on the choice of statin in patients with cardiovascular disease in a cohort study. Methods: Data analysis was performed in the Profile-I registry patients. The results of the examination of 148 patients were selected for the final analysis on the basis of the presence of indications for prescribing statins, the availability of data on the choice of statin and the availability of results of lipid spectrum from 274 registry patients. Results: The values ​​of total cholesterol and LDL-С were significantly lower in the rosuvastatin group than in the atorvastatin and simvastatin groups (respectively 4.3, 4.7 and 4.6 mmol/l, p = 0.03;2.36, 2.98, and 2.66 mmol/l, p = 0.01). Conclusion: the achievement of more optimal levels of lipid spectrum turned out to be dependent on the choice of statin in this study in favor of rosuvastatin.
The Thalamic Interneuron

The thalamic interneuron exemplified by that found in the cat’s lateral geniculate nucleus provides a potent GABAergic and thus inhibitory input to relay cells. It thus plays a key role in controlling the flow of information to cortex. The synaptic inputs from these interneurons to relay cells are particularly interesting for two reasons. First, the interneuron appears to employ two independent input/output routes: a conventional axonal one that integrates inputs onto the cell body and proximal dendrites; and an unconventional one involving dendritic outputs that are both presynaptic and postsynaptic. Cable modeling suggests that the dendritic output route is organized into numerous, functionally independent streams that are also independent of the cell body and thus action potential generation. Second, the dendritic outputs in addition to being presynaptic to relay cell dendrites, are postsynaptic chiefly to either retinal or parabrachial inputs. Details of these output synapses, which involve complex circuits known as triads found widely throughout thalamus, lead to rather speculative but testable ideas regarding how interneurons help modulate relay cell activity. It is hoped that following through some of these ideas will provide genuine insights into the functioning of this circuitry that appears key to thalamic relays.
Optimal control of biodiesel production in a batch reactor: Part I: Deterministic control

Abstract The continuing depletion of fossil fuel reserves and the increasing environmental concerns has encouraged engineers and scientists to look for an alternative, clean, and renewable fuel that can reduce the negative environmental impact. Biodiesel has been considered as one of the best candidate of one of these renewable fuels. One of the pathways to biodiesel production is the transesterification reaction of triglycerides from vegetable oils and short-chain alcohols. A batch reactor is employed for the production of biodiesel. The flexibility of the batch process allows operating the reactor with different feed stocks and product specifications. This condition becomes challenging for the reactor modeling and control since uncertainty in the feed composition turns into time-dependent uncertainty and requires a batch-process based stochastic optimal control. In the first part of this work, the optimal control in this reactor involves optimization of the concentration of fatty acid methyl esters, well known as biodiesel, under the control of reactor temperature and the strategy applied to solve this problem is based on the maximum principle. The strategy increased the concentration by 8.46%. As far as the minimum time required to obtain the same base concentration, it reduced the reaction time by 69.5%.
Mental Health, Depression, and Dimensions of Spirituality and Religion

The author explores the relationship between spirituality and religion and human growth and development, specifically examining emotional well-being during adulthood. Dimensions of spirituality to be explored are meaning in life, a transcendent purpose, intrinsic values, and spiritual community. The argument is made that spirituality is related to emotional well-being during adulthood. Implications for further research and relevant information for counselors, psychologists, and educators are included.
A consistent and cost-effective quantification of containment performance criteria

Containment performance criteria (CPC) are derived systematically, given top level safety goals related to public risk. The main focus is on the relationships between the top level safety goals and lower level design objectives, and the way in which the latter are determined. A set of CPC is identified in terms of the reliabilities of the systems that perform various containment functions. The multiobjective optimization approach is used as a method for deriving a finite manageable set of self-consistent relations between the top level safety goals and specific containment performance. As a global set of measures of plant performance or objective functions, acute and latent fatalities and the total reliability cost are chosen. The latter is included because it represents both technical and economic limitations in achieving a certain level of the first two members of the global set. A specific application is made to a large dry containment. A set of noninferior solutions (optimized solutions in a multi-objective optimization problem) is shown and discussed.
11 – Ocean sequestration of carbon dioxide (CO2)

Abstract: The deep ocean is a potential storage medium for anthropogenic carbon dioxide (CO2). However, there is strong opposition to ocean storage because of the potential acidification of large volumes of seawater around the discharge point. Furthermore, it is not clear whether international regulations would permit deep ocean discharge of anthropogenic CO2. This chapter reviews various proposals for oceanic CO2 injection designed to alleviate the acidification problem and to discharge the CO2 at sufficient depth so it will not rapidly re-emerge into the surface layer and back into the atmosphere. One proposal is described in greater detail, that of discharging the liquid CO2 in the form of an emulsion in seawater stabilized by pulverized limestone (CaCO3).
A review of the current progress of CO2 injection EOR and carbon storage in shale oil reservoirs

Abstract CO2 injection is a promising method to rejuvenate the shale oil reservoirs after the primary production. In this work, we comprehensively reviewed the CO2 injection enhanced oil recovery (EOR) and carbon storage related literature in shales over the past decade. The aspects reviewed include description of major shale reservoirs producing oil and the necessity to perform EOR, selection of injection scheme, models applied to simulate gas injection, oil recovery mechanisms for different types of gas, molecular diffusion and its laboratory measurement, nanopore effect, adsorption effect on carbon storage and transport, laboratory work of gas injection in shale cores, pilot tests, and economic evaluation. Advanced models in recent years applied to simulate these processes were introduced in details, such as the traditional dual continuum model, the embedded discrete fracture model (EDFM). Heterogeneity effect and upscaling algorithm on the shale oil recovery performance were discussed. Molecular diffusion, as an important flow and oil recovery mechanism, was described regarding its definition, empirical correlation and laboratory measurement with consideration of the porous media effect which is crucial for accurate modeling result. Recovery mechanisms by carbon dioxide, methane and nitrogen were compared at the molecule and pore levels. Pros and cons of different types of gas were evaluated as well. Pore confinement caused by the extremely tiny pores in the organic matter, along with the capillary and adsorption effects were discussed, and approaches to take them into account of the model were addressed. Core-scale gas injection experiments on shales from various institutions were described, and the results were compared. Outcomes of recent pilot tests in the Eagle Ford, and the Bakken formations were summarized, and finally, economic considerations were provided for the feasibility of gas injection in shale oil reservoirs.
An Acoustically Powered Battery-less Internet of Underwater Things Platform

The Internet of Underwater Things (IoUT) is a promising approach to future military, scientific, and commercial applications at sea. Vital components of the IoUT are underwater wireless sensor networks (UWSNs) and autonomous underwater vehicles (AUVs). Powering of these systems in deep water still remains one of the main challenges, since UWSN nodes and AUVs are typically powered by batteries that need to be replaced or recharged through expensive and difficult operations. This article presents the design of the first batteryless underwater sensor node that can be wirelessly recharged through ultrasonic waves from longer distances than allowed by current inductive and magnetic technologies. First, the architecture of an underwater platform capable of extracting electrical energy from ultrasonic waves is introduced. We then illustrate how to interface this system with an underwater digital communication unit. We discuss the design of a prototype of the proposed architecture where the storage unit is realized with a batch of supercapacitors. We show through experiments that the harvested energy stored in the supercapacitors is sufficient to provide an underwater sensor node with the power necessary to perform a sensing operation and power an acoustic modem for ultrasonic communications. We evaluate the system performance in terms of wireless power transfer efficiency (PTE). Our system is characterized by a lower electrical-to-radiated power conversion efficiency when compared to other technologies. However, given the reduced attenuation of ultrasonic waves in water, we were able to show that our approach can cover longer distances with less transmission power. Last, we evaluate the operating efficiency that we define as the maximum achievable digital data rate relative to the charging and transmission times.
Radiofrequency Ablation vs. Cryoablation for Localized Hepatocellular Carcinoma: A Propensity-matched Population Study.

BACKGROUND/AIM To compare overall survival (OS) and liver cancer-specific survival (LCSS) of Surveillance, Epidemiology and End Results (SEER) hepatocellular carcinoma (HCC) database patients treated with cryoablation (cryo) or radiofrequency ablation (RFA). MATERIALS AND METHODS This was a retrospective review of Stage I or II HCC patients from the SEER database treated with cryo and RFA from 2004-2013. Kaplan-Meier and Cox regressions were performed on pooled and propensity-matched cohort. RESULTS Out of 3,239 patients, RFA showed a significant survival advantage over cryo in liver cancer specific survival (LCSS) (HR=1.634 p=0.0004). A total of 91 propensity-matched pairs had similar OS (HR=1.006 p=0.9768), but no difference in LCSS was observed between the groups [HR=1.412 (95%CI=0.933-2.137) p=0.1023]. Survival Cox models did not reveal treatment type as an independent prognostic factor. CONCLUSION Propensity-matched cohort showed no significant difference in terms of OS and LCSS was found for patients treated with either cryo or RFA for localized HCC.
The National Glycohemoglobin Standardization Program: Over 20 Years of Improving Hemoglobin A1c Measurement

BACKGROUND: Measurement of hemoglobin A1c (HbA 1c ) in the blood is integral to and essential for the treatment of patients with diabetes mellitus. HbA 1c reflects the mean blood glucose concentration over the preceding 8 to 12 weeks. Although the clinical value of HbA 1c was initially limited by large differences in results among various methods, the investment of considerable effort to implement standardization has brought about a marked improvement in analysis. CONTENT: The focus of this review is on the substantial progress that has been achieved in enhancing the accuracy and, therefore, the clinical value of HbA 1c assays. SUMMARY: The interactions between the National Glycohemoglobin Standardization Program and manufacturers of HbA 1c methods have been instrumental in standardizing HbA 1c . Proficiency testing using whole blood has allowed accuracy-based assessment of methods in individual clinical laboratories that has made an important contribution to improving the HbA 1c measurement in patient samples. These initiatives, supported by the efforts of the IFCC network, have led to a continuing enhancement of HbA 1c methods. Many of the factors that previously influenced HbA 1c results independently of blood glucose have been eliminated from most modern methods. These include carbamylation, labile intermediates, and common hemoglobin variants. Nevertheless, some factors (e.g., race and aging) may alter HbA 1c interpretation, but whether these differences have clinical implications remains contentious. HbA 1c has a fundamental role in the diagnosis and management of diabetes. Ongoing improvements in HbA 1c measurement and quality will further enhance the clinical value of this analyte.
"Show Me the Data": A Recipe for Quality Improvement Success in an Academic Surgical Department.

Background Surgeons in academic medical centers have traditionally taken a siloed approach to reducing postoperative complications. We initiated a project focusing on transparency and sharing of data to engage surgeons in collaborative quality improvement. Its key features were the development of a comprehensive department quality dashboard and the creation of the Clinical Operations Council that oversaw quality. The purpose of this study was to assess the impact of those efforts. Study Design We compared inpatient outcomes before and after our intervention, allowing one quarter as the diffusion period. The outcomes analyzed were: risk-adjusted length of stay, mortality, direct cost and unadjusted incidence of complications, and 30-day all-cause readmissions, as determined by the Vizient Clinical Database. We examined the outcomes of three groups: group 1 (surgery); group 2, all other surgical departments (other surgery); and group 3, all other patients (non-surgery). Two-tailed Student's t-test was used for analysis and p Results Group 1 demonstrated statistically significant improvements in mortality (p = 0.01), length of stay (p = 0.002), cost (p = 0.0001), and complications (p = 0.02), and the all-cause readmission rate was unchanged, resulting in mean decrease of 0.55 length of stay days and direct cost savings of $2,300 per surgical admission. The comparison groups had only modest decreases in some of the analyzed outcomes and an increase in complication rates. Conclusions These data suggest that a collaborative, data-driven, and transparent approach to assessing the quality of surgical care can yield significant improvements in patient outcomes.
Wellenschlag des Urknalls

Die unmittelbar auf den Urknall folgende Phase der kosmischen Inflation erzeugte Gravitationswellen, die im kosmischen Strahlungshintergrund feinste Spuren hinterliesen. Die kurzlich beobachtete „Verwirbelung“ der kosmischen Mikrowellenstrahlung wird allerdings grostenteils vom Staub in der Milchstrase erzeugt. Schon bald sollen prazisere Messungen aus den galaktischen Staubsignalen die Spur der kosmischen Inflation herausfiltern (aus Spektrum der Wissenschaft 3/2015).
Prenatal exposure to an environmentally relevant phthalate mixture disrupts testicular steroidogenesis in adult male mice

Abstract Endocrine disrupting chemicals (EDCs) in the environment are considered to be a contributing factor to the decline in the sperm quality. With growing evidence of the harmful effects of EDCs on the male reproductive system, we tested the hypothesis that prenatal exposure to an environmentally relevant phthalate mixture adversely affects reproductive outcomes and androgen synthesis. In this study, an environmentally relevant composition of phthalates (15% DiNP, 21% DEHP, 36% DEP, 15% DBP, 8% DiBP, and 5% BBzP) that were detected in urine samples of pregnant women in Illinois, United States, was used. Pregnant CD-1 mice (F0) were orally dosed with a vehicle or the phthalate mixtures (20 µg/kg/day, 200 µg/kg/day, 200 mg/kg/day, or 500 mg/kg/day) from gestational day 10.5 to the day of birth. Then, the indices of the reproductive function of the F1 males born to these dams were assessed. Those male mice prenatally exposed to the phthalate mixture had smaller gonads, prostates and seminal vesicles, especially in the 20 µg/kg/day and 500 mg/kg/day phthalate mixture groups, compared to the controls. Importantly, at the age of 12 months, those prenatally exposed mice had significantly lower serum testosterone concentrations accompanied by the decreased mRNA expression of testicular steroidogenic genes (StAR, Cyp11, and Cyp17) and impaired spermatogenesis. Taken together, this study found that prenatal exposure to environmentally relevant doses of a phthalate mixture caused a life-long impact on the reproduction in male mice.
Observed Relationship Between BRF Spectral-Continuum Variance and Macroscopic Roughness of Clay Sediments

Spectral data offer a means of estimating the critical parameters of sediments, including sediment composition, moisture content, surface roughness, density, and grain-size distribution. Macroscopic surface roughness in particular has a substantial impact on the structure of the bidirectional reflectance factor (BRF) and the angular distribution of scattered light. In developing the models to invert the properties of the surface beyond just surface composition, roughness must also be accounted for in order to achieve reliable and repeatable results. This paper outlines laboratory studies in which the BRF and surface digital elevation measurements were performed on dry clay sediments. The results were used to explore the suitability of various roughness metrics to account for the radiometric effect of surface roughness. The metrics that are specifically addressed in this paper include random roughness and sill variance. Relative accuracy and tradeoffs between these metrics are described. We find that spectral variability, especially near spectral absorption features, correlates strongly with the quantified measures of surface roughness. We also find that spectral variability is sensitive to the sensor fore-optic size. The results suggest that roughness parameters might be directly determined from the spectrum itself. The relationship between spectral variability and macroscopic surface roughness was particularly strong in some broad spectral ranges of the visible, near infrared, and shortwave infrared, including the near-infrared region between 600 and 850 nm.
Intraoral Scanning and Setting Up the Digital Final Occlusion in Three-Dimensional Planning of Orthognathic Surgery: Its Comparison with the Dental Model Approach.

Background Three-dimensional surgical planning for orthognathic surgery is becoming prevalent, with improving outcomes. However, conventional dental casts are still used for evaluations, digital image conversion, surgical planning, and occlusal splint production. This study used intraoral scanning for the three-dimensional planning of the final digital occlusion and compared this method with the conventional dental cast approach. Methods Thirty consecutive patients who underwent two-jaw orthognathic surgery to treat mandibular prognathism and asymmetry were included. Dental casts (control group) and intraoral scans (study group) were collected simultaneously for designing the final dental occlusion. A step-by-step setup of the final digital occlusion was established for the study group. To validate results, the intraoral scanning-based virtual occlusion was superimposed over the dental model-based final digital occlusion for comparison. Intraobserver and interobserver variability were assessed for setting up the final digital occlusion. The fitness of splints fabricated using the conventional and virtual occlusion methods were compared. Results The steps for setting up the final digital occlusion were applicable in all cases. The average root-mean-square difference of final occlusion images between the two groups was 0.45 mm, indicating a comparable occlusal relationship. The intraobserver reproducibility and interobserver reliability for setting up the virtual occlusion were satisfactory. Moreover, no significant difference existed in the splint fitness test between the groups. Conclusions The proposed intraoral scan and setup process of the final digital occlusion was reliable and accurate. Thus, the method can replace the dental model approach for the three-dimensional planning of orthognathic surgery. Clinical question/level of evidence Therapeutic, II.
A framework for building a smart port and smart port index

Ports and harbors are facing stiff competition for market share and delivering more effective and secure flow of goods worldwide. High-performing ports are implementing smart technologies to better...
Endotracheal intubation by a specialised paediatric retrieval team.

Objectives Intubation of critically ill children is an infrequent procedure, and is associated with significant risk. We set out to describe intubations carried out by the Children's Health Queensland Retrieval Service (CHQRS), with the intention to identify areas for improvement in the performance of intubation in the retrieval setting. Methods Paediatric patients undergoing transport while intubated were identified, and cases where intubation occurred after the arrival of the CHQRS team were examined. Results Over the study period of January 2015 to September 2018, 498 intubated retrievals were undertaken; 85 patients were intubated after the arrival of CHQRS; the age range was 1 day to 16.5 years (median 0.5, interquartile range [IQR] 0.11-3 years). The median weight was 6.2 kg (IQR 3.7-16.5 kg). The pathology requiring intubation included respiratory 36 (42.3%), sepsis 21 (24.7%), neurological 11 (12.9%) and trauma 7 (8.2%). A total of 470 of 498 (94.4%) of intubated patients were from regional referral or tertiary hospitals, 28 of 498 (5.6%) were from rural and remote facilities. Of 85 patients, 57 (67.1%) were intubated by CHQRS and 28 (32.9%) were intubated by a doctor from the referring facility. The CHQRS team was more likely to perform the intubation in smaller children (median weight 5.0 vs 9.9 kg, P = 0.03). The mean scene time was 2.8 h. The scene time was shorter if the intubation was performed by CHQRS (mean 2.6 h, median 2.5, IQR 1.8-3.3; median 3, IQR 2.2-3.9; P = 0.048). The scene time was shorter when the intubation was predicted from tasking information (2.6 vs 3.1 h; P = 0.03). Conclusion Paediatric endotracheal intubation is an infrequent procedure in our service. An airway registry could improve documentation and gather information to identify specific training requirements and areas for practice improvement.
P198 Development and Validation of a Readiness to Change Tool for College Students

Background Emerging adulthood is a developmental stage in which lifestyle behaviors are established that either promote or impede health. Interventions for behavior modification often incorporate the stages of change, which are a key construct described in the transtheoretical model (TTM). There is no current assessment tool that determines how college students rate their own readiness to change and that of their administrators and peers. Objective To develop and validate a tool for college students to assess readiness to change for health. Study Design, Settings, Participants A sample of college students (n = 7,419) recruited for a larger health-related project were surveyed on readiness to change. The sample included students from 60 universities across the United States. Measurable Outcome/Analysis Survey questions were developed by a panel of six researchers with expertise in behavior change in the college population. Five dietitians were interviewed for content validation and ten college students were interviewed for face validation. Exploratory factor analysis using maximum likelihood extraction with varimax rotation was performed on a random sample of 50% of the cases, followed by a confirmatory factor analysis on the remaining 50% of the cases. Results The expert panel initially created a 28-item tool. The tool was decreased to 10 items after the interviews with dietitians. Minor changes were made to the survey following face validation. Factor analysis confirmed three factors apparent in the tool: campus community readiness (3 items, α = 0.722), campus readiness for wellness programming (3 items, α = 0.808) and student readiness (4 items, α = 0.826). Cronbach's alpha for the entire 10-item tool was 0.874. Conclusion This validated 10-item questionnaire may be used in future studies to assess college students’ readiness to change as well as for the development of campus-wide health interventions and wellness programming. Funding None.
Fundamental bounds on the age of information in multi-hop global status update networks

This paper studies the "age of information" in a general multi-source multi-hop wireless network with explicit channel contention. Specifically, the scenario considered in this paper assumes that each node in the network is both a source and a monitor of information, that all nodes wish to receive fresh status updates from all other nodes in the network, and that only one node can transmit in each time slot. Lower bounds for peak and average age of information are derived and expressed in terms of fundamental graph properties including the connected domination number. An algorithm to generate near-optimal periodic status update schedules based on sequential optimal flooding is also developed. These schedules are analytically shown to exactly achieve the peak age bound and also achieve the average age bound within an additive gap scaling linearly with the size of the network. Moreover, the results are sufficiently general to apply to any connected network topology. Illustrative numerical examples are presented which serve to verify the analysis for several canonical network topologies of arbitrary size, as well as every connected network with nine or fewer nodes.
Physiology of Potassium Regulation

On the basis of the present analysis, one may concluded that aldosterone is a major component of the system that regulates potassium over long time periods. The hormone’s participation in the control system is regulated by the multiplicative interaction of the two stimuli of aldosterone secretion, angiotensin II and plasma potassium concentration. The most prominent regulator of potassium excretion is the direct effect of changes in extracellular potassium concentration on secretion of the ion into the distal nephron. This mechanism is approximately three times as powerful as the aldosterone effect in increasing potassium excretion in response to increases in the rate of potassium intake. Aldosterone participates in control of the distribution of potassium between the intra-and extracellular spaces, a greater proportion of total body potassium being within the cells at higher levels of aldosterone. The shift in distribution can be large so that plasma potassium concentration may fall by 1.0 mmol/L or more with only small change in potassium excretion in response to a several fold increase in aldosterone concentration. Aldosterone’s most prominent function in potassium regulation is in preventing changes in potassium excretion during changes in sodium excretion. Increases in flow through the potassium-secreting portion of the distal nephron strongly augment potassium secretion. However, as distal flow increases, for example following an increase in sodium intake, aldosterone secretion decreases as a result of a reduction in renin release and angiotensin II concentration; the reduced aldosterone concentration offsets the kaliuretic influence of the increase in flow rate, so that in general, no change in potassium balance occurs. Aldosterone is not the most powerful component of the systems regulating potassium and excretion, but the aldosterone component is the only mechanism that enables the system to simultaneously maintain balance of both potassium and sodium over wide combined ranges of intakes of the two ions