cssi/SciSciGPT-SciSciNet huggingface dataset:
Issues in designing truly scalable interconnection networks

Interconnection networks have been extensively studied in the computer architecture community as they are essential to the performance of parallel processing computing platforms. However, this research area has also been criticized for producing many practically useless research results, which hinder the needed progress in this area. This paper begins with a new classification of interconnection networks and then discusses major practical issues in the design of interconnection networks. The emphasis will be on "truly scalable" interconnection networks. A more practical definition of "incremental scalability" is elaborated. Just like the evolution of microprocessors, as technology advances, the architecture of interconnection networks may also change. Understanding those technological constraints and performance demands is important to future research in this area.
Variables Affecting Learning in a Simulation Experience: A Mixed Methods Study

The primary purpose of this study was to test a hypothesized model describing the direct effects of learning variables on anxiety and cognitive learning outcomes in a high-fidelity simulation (HFS) experience. The secondary purpose was to explain and explore student perceptions concerning the qualities and context of HFS affecting anxiety and learning. This study used a mixed methods quantitative-dominant explanatory design with concurrent qualitative data collection to examine variables affecting learning in undergraduate, beginning nursing students (N = 124). Being ready to learn, having a strong auditory-verbal learning style, and being prepared for simulation directly affected anxiety, whereas learning outcomes were directly affected by having strong auditory-verbal and hands-on learning styles. Anxiety did not quantitatively mediate cognitive learning outcomes as theorized, although students qualitatively reported debilitating levels of anxiety. This study advances nursing education science by providing evidence concerning variables affecting learning outcomes in HFS.
Structure of microsomal cytochrome P450 2B4 complexed with the antifungal drug bifonazole: insight into P450 conformational plasticity and membrane interaction.

To better understand ligand-induced structural transitions in cytochrome P450 2B4, protein-ligand interactions were investigated using a bulky inhibitor. Bifonazole, a broad spectrum antifungal agent, inhibits monooxygenase activity and induces a type II binding spectrum in 2B4dH(H226Y), a modified enzyme previously crystallized in the presence of 4-(4-chlorophenyl)imidazole (CPI). Isothermal titration calorimetry and tryptophan fluorescence quenching indicate no significant burial of protein apolar surface nor altered accessibility of Trp-121 upon bifonazole binding, in contrast to recent results with CPI. A 2.3 A crystal structure of 2B4-bifonazole reveals a novel open conformation with ligand bound in the active site, which is significantly different from either the U-shaped cleft of ligand-free 2B4 or the small active site pocket of 2B4-CPI. The O-shaped active site cleft of 2B4-bifonazole is widely open in the middle but narrow at the top. A bifonazole molecule occupies the bottom of the active site cleft, where helix I is bent ∼15° to accommodate the bulky ligand. The structure also defines unanticipated interactions between helix C residues and bifonazole, suggesting an important role of helix C in azole recognition by mammalian P450s. Comparison of the ligand-free 2B4 structure, the 2B4-CPI structure, and the 2B4-bifonazole structure identifies structurally plastic regions that undergo correlated conformational changes in response to ligand binding. The most plastic regions are putative membrane-binding motifs involved in substrate access or substrate binding. The results allow us to model the membrane-associated state of P450 and provide insight into how lipophilic substrates access the buried active site.
Imaging of Skull Base Cerebrospinal Fluid Leaks in Adults

Cerebrospinal fluid (CSF) leak occurs when there is an osseous and dural defect at the skull base, with direct communication of the subarachnoid space to the extracranial space, usually a paranasal sinus. Recognition of the leak site and source and appropriate treatment are necessary to avoid rhinorrhea or otorrhea, low-pressure headaches, and meningitis, known complications of CSF leak. The imaging evaluation has evolved over the past several decades. Description of current techniques available to direct treatment options, including multidetector thin-section computed tomography, and imaging recommendations are presented.
Enhancing the Student Listening Skills and Environment

This article reports the results of an investigation using an interactive approach to teaching listening skills that appears to be ideal for a business communication class. The authors describe the...
Surface currents on conducting plates with multiple apertures

The surface current distribution on a conductive scatterer gives an insight into the dominant scattering mechanisms by defining regions that contribute the most to the backscattered radar cross section. A map of the surface current density identifies the "hot spots" of current on the scatterer. It could help one establish where to place antennas to achieve minimal interference from the scatterer to the antenna. The paper discusses the characteristics of the surface currents induced by a plane wave incident on a plate with multiple apertures. The moment method surface patch formulation is used to compute the surface current density for a solid plate, plates with widely-spaced apertures, and plates with closely-spaced apertures. The effects of the aperture separation and incident wave polarization on the currents are discussed. Surface current maps determined by the method of moments (MoM) are compared with surface currents computed by the physical optics (PO) approximation. These comparisons are used to explain the difference between the MoM and PO predicted RCS results. >
A plasma-optical system modelled using particles

Modelisation du systeme optique-plasma qui supprime les gouttelettes macroscopiques d'un faisceau neutralise d'ions et d'electrons produit par un arc. Le modele de particules traite le mouvement des electrons a travers un gaz de fond, constitue de particules neutres. Simulation de Monte Carlo de la distribution cumulative des distances parcourues par les electrons au cours des collisions avec le fond neutre
Natural joins in relational databases with indefinite and maybe information

Natural joins are defined, in a semantically correct way, on data structures, called I-tables, of an extended relational database model with indefinite and maybe information. An algorithm for computing natural joins under the extended model is proposed which reduces the number of pair-up operations and block accesses to a linear order of complexity with respect to the size of I-tables. Procedures for the extended natural joins are examined with respect to efficiency, which is evaluated based upon the number of pair-up operations and I/O block accesses. A linear order of pair-up operations is achieved by using the 'compare, concatenate, and then permute' strategy, and a linear order of I/O activities is attained by employing virtual relations with pointers. >
Stochastic Ordering Based Carrier-to-Interference Ratio Analysis for the Shotgun Cellular Systems

An analytical tool based on usual stochastic ordering is developed to compare the distributions of carrier-to-interference ratio at the mobile station of cellular systems where the base stations are distributed randomly according to certain non-homogeneous Poisson point processes. The comparison is done by studying the base station densities without having to solve for the distributions of the carrier-to-interference ratio, which are often hard to obtain.
Attentional control parameters following parietal-lobe damage: evidence from normal subjects.

Abstract Attentional control involves the factors, or cognitive parameters, that determine which environmental inputs receive attention and which do not. Cognitive studies of attentional control have highlighted two general classes of control parameters, bottom-up (data driven or exogenous) parameters and top-down (goal driven or endogenous) parameters. Which of these control parameters is affected following parietal-lobe damage? In parietal-damaged patients, it is possible that a disorder in one control parameter (e.g. goal driven) would appear as a disorder in another parameter (e.g. data driven). To investigate the control parameters that might be affected in parietal patients, we simulated neglect in normal participants by disrupting data-driven information processing. When half of a computer monitor was degraded by translucent tracing paper while normal participants performed a cued spatial attention task (Experiment 1), the normal participants showed a pattern of results similar to patients with unilateral parietal-lobe damage—the so-called “disengage deficit.” This pattern of results replicated when neutral attentional cues were included in the experiment (Experiment 2). However, the disengage deficit was not simulated in normal participants with predictive central symbolic cues (Experiment 3) or predictive peripheral cues (Experiment 4). Because perceptual degradation influences data-driven attentional control parameters, we suggest that these control parameters may be disrupted following parietal-lobe damage.
A child psychiatry chairman's view.

During my 50 years as a child and adolescent psychiatrist, through posts including president of the American Psychoanalytic Association, the American Academy of Child and Adolescent Psychiatry, the Association of Child Psychoanalysis, and the International Association of Child and Adolescent Psychiatry, chairman of a department of child psychiatry, and, more recently, as Connecticut’s Commissioner of Mental Health and Addiction Services from 1991 to 2000, I have come to the strong belief that child psychiatry is best challenged and most likely to exploit constructively its historical roots and its present and future opportunities when it is autonomous. In its role as an independent agency, child psychiatry also can be a more productively collaborative partner in working together with adult psychiatry, pediatrics, and all the allied biologic and social science disciplines concerned with advancing our knowledge, priorities, and care about and for children. In the past 40 years, there have been two major changes in approaches to mental health services evoked by changing perspectives and newer knowledge. The first change was the introduction of epidemiologic public health knowledge and values into the needs assessment, availability, and outreach initiatives of mental health services in the community. The First White House Commission on Mental Health Services in the early 1960s led to the development of community mental health centers and programs. This was during the leadership of President John F. Kennedy.
Effects of process conditions on crystals obtained from supercritical mixtures

Etude de la dimension des grains obtenus en fonction des conditions de temperature et de pression de pre et post-expansion. On etudie la cristallisation d'une poudre de naphtalene
Independent biosynthesis of soluble and membrane-bound alkaline phosphatases in the suckling rat ileum

Enzymically active intestinal alkaline phosphatase exists in both soluble and membrane-bound forms in the suckling rat. Antiserum prepared against purified soluble alkaline phosphatase (anti-AlP) was shown to be monospecific when assessed by Ouchterlony double-diffusion analysis and immunoelectrophoresis. The two forms of alkaline phosphatase were antigenically identical and possessed similar affinities for anti-AlP. To study the biosynthesis of the two forms, 14-day-old rats were injected intraperitoneally with [3H]leucine. The labelling kinetics of alkaline phosphatase, extracted from supernatant and brush-border membrane fractions with anti-AlP, was followed over 20h. Incorporation of [3H]leucine into membrane-bound alkaline phosphatase was rapid, reaching a plateau at 6h. The soluble enzyme showed slower incorporation of label and maximal radioactivity was not reached until 12h after labelling, a lag of 6h behind the membrane-bound enzyme. Soluble alkaline phosphatase could not have been a precursor of the membrane form, as there was no early peak of radioactivity in the soluble form. To determine if the soluble enzyme was irreversibly derived from the membrane enzyme, a newly developed technique of labelling brush-border membrane proteins in vivo by intraluminal injection of diazotized [125I]iodosulphanilic acid was used. The appearance of 125I in soluble and membrane alkaline phosphatase was then monitored over a 7h period, encompassing the lag between maximal leucine labelling of the two forms. The results failed to show either a proportional transfer of radioactivity from membrane to soluble alkaline phosphatase or an absolute increase in radioactivity of the soluble form during degradation of brush-border alkaline phosphatase. Therefore there does not appear to be a serial precursor/product relationship between the soluble and membrane-bound forms of suckling-rat intestinal alkaline phosphatase.
Toward Non-intrusive Assessment in Dialogue-Based Intelligent Tutoring Systems

This paper describes a study whose goal was to assess students’ prior knowledge level with respect to a target domain based solely on characteristics of the natural language interaction between students and a state-of-the-art conversational ITS. We report results on data collected from two conversational ITSs: a micro-adaptive-only ITS and a fully adaptive (micro- and macro-adaptive) ITS. Our models rely on both dialogue and session interaction features including time-on-task, student-generated content features (e.g., vocabulary size or domain-specific concept use), and pedagogy-related features (e.g., level of scaffolding measured as number of hints). Linear regression models were explored based on these features in order to predict students’ knowledge level, as measured with a multiple-choice pre-test, and yielded in the best cases an r = 0.949 and adjusted r-square = 0.878.
Cell orientation entropy (COrE): predicting biochemical recurrence from prostate cancer tissue microarrays.

We introduce a novel feature descriptor to describe cancer cells called Cell Orientation Entropy (COrE). The main objective of this work is to employ COrE to quantitatively model disorder of cell/nuclear orientation within local neighborhoods and evaluate whether these measurements of directional disorder are correlated with biochemical recurrence (BCR) in prostate cancer (CaP) patients. COrE has a number of novel attributes that are unique to digital pathology image analysis. Firstly, it is the first rigorous attempt to quantitatively model cell/nuclear orientation. Secondly, it provides for modeling of local cell networks via construction of subgraphs. Thirdly, it allows for quantifying the disorder in local cell orientation via second order statistical features. We evaluated the ability of 39 COrE features to capture the characteristics of cell orientation in CaP tissue microarray (TMA) images in order to predict 10 year BCR in men with CaP following radical prostatectomy. Randomized 3-fold cross-validation via a random forest classifier evaluated on a combination of COrE and other nuclear features achieved an accuracy of 82.7 ± 3.1% on a dataset of 19 BCR and 20 non-recurrence patients. Our results suggest that COrE features could be extended to characterize disease states in other histological cancer images in addition to prostate cancer.
Susceptibility of preevisceration washed beef carcasses to contamination by Escherichia coli O157:H7 and salmonellae

Prerigor bovine cutaneous truncii muscle was subjected to a simulated preevisceration wash procedure 10 min after the hide was removed from the carcass. Five minutes after washing, the preevisceration washed tissue and unwashed control tissues were contaminated with a direct application of either fresh bovine manure or bovine manure which had been inoculated with five-strain mixtures of either Escherichia coli O157:H7 or salmonellae to simulate fecal contamination on a carcass. The manure which was inoculated with the bacteria had been previously irradiated to eliminate enterobacteriaceae. The contamination was allowed to adhere to the tissues for 10 min and then washed off with distilled water. Surface free energy of the preevisceration washed tissue was significantly lower than that of tissue which had not been subjected to preevisceration washing. Scanning electron micrographs of the tissue samples revealed plant material adhering to the surface of the control tissues, but not to the preevisceration washed tissues. Microbial populations of both total aerobic bacteria and enterobacteriaceae were approximately 0.7 log10 unit greater on the control tissue, in comparison to the preevisceration washed tissue. Preevisceration washing may be beneficial in reducing the susceptibility of animal carcasses to further contamination.
The Journal of Herpetology After 50 Years Plus: A Brief History (1958–2016)1

Abstract The Journal of Herpetology (JH), which reached its 50th volume in 2016, had an unusual start. Its predecessor publication was founded in 1958 by high school students as the Journal of The Ohio Herpetological Society (JOHS), which was sponsored by an amateur organization. The scope of the journal as well as that of the society soon became broader than Ohio or even North America. In 1967 OHS transformed into the Society for the Study of Amphibians and Reptiles (SSAR), which today is the largest professional herpetological society in the world. The journal was re-named Journal of Herpetology in 1968 and the volumes numbered again from 1. The journal, like SSAR, grew rapidly in size and professionalism. In 2009, JH was selected as one of the “100 most influential journals in biology and medicine worldwide over the last 100 years.” Originally, taxonomy–systematics (37%), ecology (20%), behavior (16%), physiology (8%), and genetics (4%) predominated as topics in JH; today, ecology (28%), conservation (...
Foodborne Outbreaks Reported to the U.S. Food Safety and Inspection Service, Fiscal Years 2007 through 2012

ABSTRACT The U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) works closely with federal, state, and local public health partners to investigate foodborne illness outbreaks associated with its regulated products. To provide insight into outbreaks associated with meat and poultry, outbreaks reported to FSIS during fiscal years 2007 through 2012 were evaluated. Outbreaks were classified according to the strength of evidence linking them to an FSIS-regulated product and by their epidemiological, etiological, and vehicle characteristics. Differences in outbreak characteristics between the period 2007 through 2009 and the period 2010 through 2012 were assessed using a chi-square test or Mann-Whitney U test. Of the 163 reported outbreaks eligible for analysis, 89 (55%) were identified as possibly linked to FSIS-regulated products and 74 (45%) were definitively linked to FSIS-regulated products. Overall, these outbreaks were associated with 4,132 illnesses, 772 hospitalizations, and 19 ...
Aortoiliac vascular injuries after misplacement of fixation screws.

Purpose To report our experience with the diagnosis and treatment of aortoiliac vascular injuries caused by misplaced orthopedic fixation screws. Materials Six patients (age range, 35-60 years; mean, 52 years) were diagnosed with seven arterial injuries related to misplacement of fixation screws. The location of the injuries were thoracic aorta (n = 4) and common iliac arteries (n = 3). There was vessel wall penetration in five injuries resulting in active bleeding in two patients, contained penetrations in two patients, and vessel occlusion in one patient. One patient had associated inferior vena cava injury and pulmonary embolism. Two patients had asymptomatic impingement of the aortic wall by the screws. Results Vascular injuries resulted in death in one patient and limb amputation in another patient. Three patients were treated with placement of stent grafts and screw removal. Screw replacement was performed in one patient. Conservative observation was done in one patient. Conclusions Vascular injuries related to misplacement of fixation screws are relatively infrequent but potential life and limb-threatening complications that require early recognition with prompt repair of vascular lesions and screw reposition.
The Development of a Minority Recruitment Plan for Cancer Clinical Trials.

Background: Cancer does not occur in all ethnic and racial groups at similar rates. In addition, responses to treatment also vary in certain ethnic and racial groups. For Hispanics, the overall cancer incidence is generally lower yet for some specific tumor types, the incidence rates are higher compared to other populations. Objectives: Although disparities are recognized for treatment outcomes and prevention methodologies for Hispanics and other minority populations, specific recruiting and reporting of minorities remains a challenge. In order to circumvent this problem, the Cancer Therapy and Research Center (CTRC) has developed a new minority recruitment plan for all cancer related clinical trials at this Institute. The overall goal of this initiative is to increase the accrual of minorities in cancer clinical trials by implementing several key interventions. Method: The Cancer Therapy & Research Center (CTRC) at the University of Texas Health Science Center at San Antonio established the Clinical Trials Accrual Task Force to develop and monitor interventions designed to increase accrual to cancer clinical trials, specifically the accrual of minorities with a focus on the Hispanic population that makes up 68% of the CTRC’s catchment area. Results: A Minority Accrual Plan (MAP) was implemented in March 2013 as part of the process for initiating and conducting cancer-related clinical trials at the CTRC. The Minority Accrual Plan focuses on Hispanic enrollment due to the characteristics of the South Texas population served by the CTRC but could be easily adapted to other populations. Conclusions: The CTRC has designed a process to prospectively address the challenge of deliberately enrolling minority subjects and accurately accounting for the results by implementing a Minority Accrual Plan for every cancerrelated clinical trial at CTRC.
Model System for the Study of Gonorrhea Created by Cell-Tissue Electrofusion

An increased understanding of receptor mediated processes of species specific pathogens can be obtained by creating novel animal models which possess distinctive features that differ fundamentally from those biological properties displayed naturally by the unaltered animal species. For example, the pathogenesis of certain infectious diseases of importance to human and veterinary medicine is initiated by the binding of the etiological agents directly to host or tissue specific microbial receptors located on cell surfaces. Therefore, biologically relevant animal models for these particular infectious diseases could theoretically be established by transferring cells that contain the appropriate microbial attachment receptors to selected tissues of common laboratory animals. The histologically modified animals should now become susceptible to infection by those host and tissue restricted microbial pathogens to which the unaltered animals are naturally resistant.
366 BRAIN CHANGES IN PATIENTS WITH ALZHEIMER'S DISEASE.

The brains of patients who die with Alzheimer9s disease demonstrate characteristic microscopic as well as macroscopic abnormalities; brain autopsy includes assessment of both types of abnormality. Microscopically, intraneuronal neurofibrillary changes and extracellular β-amyloid deposition can be revealed by immunohistochemistry performed on brain tissue. Visualization, while subjective, allows an experienced pathologist to assess macroscopic changes such as brain atrophy and ventricular enlargement. These changes, while associated with Alzheimer9s disease, may also be seen in normal aging, the difference being the extent and distribution of the changes. In this study, 155 autopsy protocols of patients diagnosed with Alzheimer9s disease were reviewed. Three gross parameters—degree of cortical atrophy, degree of ventriculomegaly, and fresh brain weight—were examined as a function of AD severity, as well as correlated to the microscopic progression of AD as determined by Braak staging. It has long been assumed that the microscopic progression of AD is paralleled by concomitant brain atrophy and ventricular enlargement. The findings of this study confirm this hypothesis of association.
A Study on Outsourcing of Self-Service Library

Self-service library has got a rapid development interiorly,and outsourcing plays an important role in it.This paper makes an overview of the practice of self-service libraries in China and other countries,and also summarizes the contents of out- sourcing of the self-service libraries,including the research and development of systems and equipment,routine maintenance and repair,logistics management,and reader training.It analyses the peculiarities and countermeasures.From five aspects of outsourcing,basic situation,contents,management models,key factors for successful outsourcing and evaluation,the paper takes Shenzhen Library 24hours self-service library system as a case to study.At last it suggests that the funding problems, process specifications,and quality control should be improved in the future.
Method Research on Parameter Optimization in Composite Sliding Pressure Operation of Large Scale Steam Turbine

Subjected to the factors such as performance of main and auxiliary equipments,local system layout and ambient temperature and so on,operational parameters inevitably deviate from design value which the manufacturer provides in composite sliding pressure operation,so it's very necessary to carry on parameter optimization after unit to be put into operation.On basis of traditional methods research on parameter optimization,parameter optimization method based on possible pressure is proposed,which is based on possible pressure computation.Parameter optimization process is effectively simplified by means of prudently selecting test condition to farthest reduce test condition.The example validates feasibility of method.
Stroke Prevention in Atrial Fibrillation and Valvular Heart Disease

There is a clinically staggering burden of disease stemming from cerebrovascular events, of which a majority are ischemic in nature and many are precipitated by atrial fibrillation (AF). AF can occur in isolation or in association with myocardial or structural heart disease. In the latter case, and when considering health at an international level, congenital and acquired valve-related diseases are frequent contributors to the current pandemic of AF and its clinical impact. Guidelines crafted by the American Heart Association, American College of Cardiology, European Society of Cardiology and Heart Rhythm Society underscore the use of vitamin K antagonists (VKAs) among patients with valvular heart disease, particularly in the presence of concomitant AF, to reduce the risk of ischemic stroke of cardioembolic origin; however, the non-VKAs, also referred to as direct, target-specific or new oral anticoagulants (NOACs), have not been actively studied in this particular population. In fact, each of the new agents is approved in patients with AF not caused by a valve problem. The aim of our review is to carefully examine the available evidence from pivotal phase 3 clinical trials of NOACs and determine how they might perform in patients with AF and concomitant valvular heart disease.
Partisan Cartographers During the Kansas-Missouri Border War, 1854–1861

A precursor to the American Civil War erupted in Kansas in 1854 after the U.S. Congress gave homesteaders in the Kansas Territory, newly opened for settlement, the right to vote whether Kansas would be a free or slave-holding state. Conflict between settlers from adjoining slave-holding Missouri and anti-slavery settlers from New England resulted in the guerrilla-style Kansas-Missouri Border War, 1854–1861. At the same time, the Territory was being surveyed and mapped for settlement according to the Public Land Survey System. Surviving documents reveal how political views and cartographic activities mingled in the lives of three surveyors active in Douglas County, the site of both Lecompton, the early pro-slavery capital of Kansas, and Lawrence, the Free-State headquarters. While surveying and mapping the Kansas Territory, Albert Dwight Searl, Isaac Cooper Stuck, and John Brown not only promoted its settlement but also put their lives on the line in opposition to slavery.
Beyond the SNARE: Munc18-1 chaperones α-synuclein.

Early infantile epileptic encephalopathy (EIEE)–associated mutations in MUNC18-1 cause Munc18-1 misfolding and cellular aggregation. In this issue, Chai et al. (2016. J. Cell Biol . http://dx.doi.org/10.1083/jcb.201512016) find that Munc18-1 is a molecular chaperone for α-synuclein and that aggregated Munc18-1 EIEE-causing mutants promote α-synuclein aggregation.
Genomic Analysis Reveals Novel Diversity among the 1976 Philadelphia Legionnaires' Disease Outbreak Isolates and Additional ST36 Strains.

Legionella pneumophila was first recognized as a cause of severe and potentially fatal pneumonia during a large-scale outbreak of Legionnaires’ disease (LD) at a Pennsylvania veterans’ convention in Philadelphia, 1976. The ensuing investigation and recovery of four clinical isolates launched the fields of Legionella epidemiology and scientific research. Only one of the original isolates, “Philadelphia-1”, has been widely distributed or extensively studied. Here we describe the whole-genome sequencing (WGS), complete assembly, and comparative analysis of all Philadelphia LD strains recovered from that investigation, along with L. pneumophila isolates sharing the Philadelphia sequence type (ST36). Analyses revealed that the 1976 outbreak was due to multiple serogroup 1 strains within the same genetic lineage, differentiated by an actively mobilized, self-replicating episome that is shared with L. pneumophila str. Paris, and two large, horizontally-transferred genomic loci, among other polymorphisms. We also found a completely unassociated ST36 strain that displayed remarkable genetic similarity to the historical Philadelphia isolates. This similar strain implies the presence of a potential clonal population, and suggests important implications may exist for considering epidemiological context when interpreting phylogenetic relationships among outbreak-associated isolates. Additional extensive archival research identified the Philadelphia isolate associated with a non-Legionnaire case of “Broad Street pneumonia”, and provided new historical and genetic insights into the 1976 epidemic. This retrospective analysis has underscored the utility of fully-assembled WGS data for Legionella outbreak investigations, highlighting the increased resolution that comes from long-read sequencing and a sequence type-matched genomic data set.
Differences in Access to and Use of Electronic Personal Health Information Between Rural and Urban Residents in the United States

Purpose The increase in use of health information technologies (HIT) presents new opportunities for patient engagement and self-management. Patients in rural areas stand to benefit especially from increased access to health care tools and electronic communication with providers. We assessed the adoption of 4 HIT tools over time by rural or urban residency. Methods Analyses were conducted using data from 7 iterations of the National Cancer Institute's Health Information National Trends Survey (HINTS; 2003-2014). Rural/urban residency was based on the USDA's 2003 Rural-Urban Continuum Codes. Outcomes of interest included managing personal health information online; whether providers maintain electronic health records (EHRs); e-mailing health care providers; and purchasing medicine online. Bivariate analyses and logistic regression were used to assess relationships between geography and outcomes, controlling for sociodemographic characteristics. Findings In total, 6,043 (17.6%, weighted) of the 33,749 respondents across the 7 administrations of HINTS lived in rural areas. Rural participants were less likely to report regular access to Internet (OR = 0.70, 95% CI = 0.61-0.80). Rural respondents were neither more nor less likely to report that their health care providers maintained EHRs than were urban respondents; however, they had decreased odds of managing personal health information online (OR = 0.59, 95% CI = 0.40-0.78) and e-mailing health care providers (OR = 0.62, 95% CI = 0.49-0.77). Conclusions The digital divide between rural and urban residents extends to HIT. Additional investigation is needed to determine whether the decreased use of HIT may be due to lack of Internet connectivity or awareness of these tools.
New transformed features generated by deep bottleneck extractor and a GMM–UBM classifier for speaker age and gender classification

Speaker age and gender classification is one of the most challenging problems in speech signal processing. Recently with developing technologies, identifying speaker age and gender information has become a necessity for speaker verification and identification systems such as identifying suspects in criminal cases, improving human–machine interaction, and adapting music for awaiting people queue. Despite the intensive studies that have been conducted to extract descriptive and distinctive features, the classification accuracies are still not satisfactory. In this work, a model for generating bottleneck features from a deep neural network and a Gaussian Mixture Model–Universal Background Model (GMM–UBM) classifier are proposed for speaker age and gender classification problem. Deep neural network with a bottleneck layer is trained in an unsupervised manner for calculating the initial weights between layers. Then, it is trained and tuned in a supervised manner to generate transformed mel-frequency cepstral coefficients (T-MFCCs). The GMM–UBM is used to build a GMM model for each class, and the models are used to classify speaker age and gender. Age-annotated database of German telephone speech (aGender) is used to evaluate the proposed classification system. The newly generated T-MFCCs have shown potential to achieve significant classification improvements in speaker age and gender classification by using the GMM–UBM classifier. The proposed classification system achieved an overall accuracy of 57.63%. The highest accuracy is calculated as 72.97% for adult female speakers.
The Impact of Symptoms of Depression and Walking on Gestational Age at Birth in African American Women

Abstract Background Symptoms of depression have been related to lower gestational age and preterm birth ( Methods This was a secondary analysis of available data of African American women. Women were interviewed within 3 days after birth. We proposed a model in which walking for a purpose during pregnancy mediated the effects of symptoms of depression (measured by the 20-item Center for Epidemiologic Studies-Depression [CES-D] scale) on gestational age at birth in a sample of 1,382 African American women. Results Using structural equation modeling, we found that the direct effect of CES-D scores of 23 or greater, which have been correlated with major depression diagnosis, on gestational age at birth was -4.23 (p Conclusions Compared with African American women without symptoms of depression, African American women who had symptoms of depression walked less for a purpose during their pregnancy and delivered infants with lower gestational age at birth. If not medically contraindicated, clinicians should incorporate walking as part of prenatal care recommendations and reassure women about safety of walking during pregnancy.
Outpatient Laparoscopic Appendectomy: Feasible in a Public County Hospital?

Background Outpatient laparoscopic appendectomy is being used increasingly as a treatment option for acute, uncomplicated appendicitis. This was a prospective validation study in a large, urban, public safety-net hospital. Study Design From 2014 to 2016, all patients undergoing laparoscopic appendectomy for acute, uncomplicated appendicitis were enrolled in a prospective observational trial. Standard baseline perioperative practice (control group) was documented for 1 year. An outpatient appendectomy protocol was then introduced. Inclusion criteria required intraoperative confirmation of uncomplicated appendicitis and strict discharge criteria, including physician assessment before discharge. Data collection then continued for 1 year (outpatient group). The outcomes measures examined included complications, length of stay, nursing transitions, emergency department visits, readmissions, and patient satisfaction. Results The study enrolled 351 patients (178 control, 173 outpatient). Of the 173 candidates for outpatient appendectomy, 113 went home. Reasons for admission included surgeon discretion due to intraoperative findings/medical comorbidities and lack of transportation home. The outpatient group had shorter operative time (69 vs 83 minutes; p Conclusions Outpatient appendectomy is safe in a public hospital and results in shorter hospital length of stay and decreased healthcare costs. Strict criteria for discharge are important to identify patients who should be admitted for observation.
School health implementation tools: a mixed methods evaluation of factors influencing their use.

The U.S. Centers for Disease Control and Prevention (CDC) develops tools to support implementation of evidence-based interventions for school health. To advance understanding of factors influencing the use of these implementation tools, we conducted an evaluation of state, school district, and local school staffs’ use of four CDC tools to support implementation of physical activity, nutrition, health education, and parent engagement. Two frameworks guided the evaluation: Interactive Systems Framework (ISF) for Dissemination and Implementation and Consolidated Framework for Implementation Research (CFIR). The evaluation applied a mixed methods, cross-sectional design that included online surveys (n = 69 state staff from 43 states), phone interviews (n = 13 state staff from 6 states), and in-person interviews (n = 90 district and school staff from 8 districts in 5 states). Descriptive analyses were applied to surveys and content analysis to interviews. The survey found that the majority of state staff surveyed was aware of three of the CDC tools but most were knowledgeable and confident in their ability to use only two. These same two tools were the ones for which states were most likely to have provided training and technical assistance in the past year. Interviews provided insight into how tools were used and why use varied, with themes organized within the ISF domain “support strategies” (e.g., training, technical assistance) and four CFIR domains: (1) characteristics of tools, (2) inner setting, (3) outer setting, and (4) individuals. Overall, tools were valued for the credibility of their source (CDC) and evidence strength and quality. Respondents reported that tools were too complex for use by school staff. However, if tools were adaptable and compatible with inner and outer setting factors, state and district staff were willing and able to adapt tools for school use. Implementation tools are essential to supporting broad-scale implementation of evidence-based interventions. This study illustrates how CFIR and ISF might be applied to evaluate factors influencing tools’ use and provides recommendations for designing tools to fit within the multi-tiered systems involved in promoting, supporting, and implementing evidence-based interventions in schools. Findings have relevance for the design of implementation tools for use by other multi-tiered systems.
In suspected OSA, home respiratory polygraphy was noninferior to polysomnography for reducing symptoms

Source Citation Corral J, Sanchez-Quiroga MA, Carmona-Bernal C, et al; Spanish Sleep Network. Conventional polysomnography is not necessary for the management of most patients with suspected obstru...
Effect of the SiO2 support on the catalytic performance of Ag/ZrO2/SiO2 catalysts for the single-bed production of butadiene from ethanol

Abstract A ternary Ag/ZrO2/SiO2 catalyst system was studied for single-step conversion of ethanol to butadiene by varying the catalyst composition (Ag, Ir, or Pt metal component, Ag/ZrO2 loading, and choice of SiO2 support) and operating conditions (space velocity and feed gas composition). Exceptional catalytic performance was achieved over a 1%Ag/4%ZrO2/SiO2-SBA-16 catalyst leading to 99% conversion and 71% butadiene selectivity while operating under mild conditions (325 °C, 1 atm, and 0.23 h−1). Several classes of silica—silica gels, fumed silicas, mesoporous silicas)—were evaluated as catalyst supports, and SBA-16 was found to be the most promising choice. The SiO2 support was found to significantly influence both conversion and selectivity. A higher SiO2 catalyst surface area facilitates increased Ag dispersion which leads to greater conversion due to the accelerated initial ethanol dehydrogenation reaction step. By independently varying Ag and ZrO2 loading, Ag was found to be the main component that affects ethanol conversion. ZrO2 loading and thus Lewis acid sites concentration was found to have little impact on the ethanol conversion. Butadiene selectivity depends on the concentration of Lewis acid site, which in turn differs depending on the choice of SiO2 support material. We observed a direct relationship between butadiene selectivity and concentration of Lewis acid sites. Butadiene selectivity decreases as the concentration of Lewis acid sites increases, which corresponds to an increase in ethanol dehydration to ethylene and diethyl ether. Additionally, adding H2 to the feed had little effect on conversion while improving catalytic stability; however, selectivity to butadiene decreased. Finally, catalyst regenerability was successfully demonstrated for several cycles.
Does School Screening Affect Scoliosis Curve Magnitude at Presentation to a Pediatric Orthopedic Clinic

Abstract Background With new data supporting the efficacy of bracing, the role of school screening for early detection of moderate scoliosis curves has been revisited. Because of a high rate of false-positive screening and cost concerns, a comprehensive county-wide school screening program was discontinued in 2004. We aim to determine the impact of a comprehensive school screening program on curve magnitude at presentation and initial scoliosis treatment for all local county patients presenting to a pediatric orthopedic clinic from all referral sources. Methods Between 1994 and 2014, a total of 761 county patients presented to a pediatric orthopedic clinic for new scoliosis evaluation. Curve magnitude and recommended treatment were recorded. Treatment indications for bracing, surgery, and observation were consistent over the study period. Results From January 1994 to July 2004 (school screening period), 514 children were seen by a pediatric orthopedic specialist for scoliosis evaluation compared to 247 patients from August 2004 to December 2014 (no school screening). There was a 48% decrease in the number of county children who were evaluated for idiopathic scoliosis by pediatric orthopedics once school screening was discontinued. Mean maximal Cobb angle at presentation increased from 20° (range, 4°–65°) to 23° (range, 7°–57°). At presentation, 5 of 514 (0.97%) patients in the screened group required surgery and 68 of 514 (13.2%) required bracing, compared to 3 of 247 (1.2%) patients in the nonscreened group requiring surgery and 47 of 247 (19%) requiring bracing (p>.05, p=.04, respectively). Conclusion After school screening was discontinued, mean curve magnitude and rates of bracing at presentation statistically increased in county patients evaluated for new scoliosis, although the clinical significance is unclear. After school screening was discontinued, there were fewer patient referrals, braces prescribed, and unnecessary evaluations (patients discharged at first visit). This study provides data to evaluate the role of school screening for children with regular access to health care. Level of Evidence Level 3.
Impact of Performance Status and Comorbidity on Palliative Radiation Treatment Tolerance and End-Of-Life Decision-Making.

Purpose Previous studies have indicated a relationship between functional status and comorbidity on overall survival when treating patients with bone and brain metastases. However, the degree to which these findings have been integrated into modern-day practice remains unknown. This study examines the impact of performance measures, including Karnofsky Performance Status (KPS) and comorbidity, on palliative radiation therapy treatment tolerance and fractionation schedule. The relationship between a shorter fractionation schedule (SFx) and pending mortality is examined. Methods and materials This study included patients who were treated with palliative intent to the brain or bone between January 1, 2016 and June 30, 2016. Demographic and medical characteristics collected included KPS score (stratified as good [90-100], fair [70-80], and poor (≤60]), socioeconomic status, comorbidity (binary measure using the Adult Comorbidity Evaluation-27 scale), site of metastatic disease, and treatment facility. Univariable analyses were performed using the Cox proportional hazards regression model to assess the impact of the variables on the prescribed number of fractions (binary measure, ≥10 [long fractionation schedule], and <10 [SFx]), and major treatment interruptions (MTIs; defined as missing ≥3 radiation therapy treatment days or ending treatment prematurely). Results A total of 145 patients were eligible for study inclusion, including 95 patients who were treated for bony metastatic disease and 50 patients for brain metastases. High comorbidity (P = .029) and both fair (P = .051) and poor (P = .065) functional status were associated with more frequent MTIs. However, high comorbidity and low KPS score were not associated with shorter treatment plans. In addition, patients with an earlier time to death were not more likely to receive an SFx (P = .871). Conclusions Low KPS and elevated comorbidity scores predict for a poorer prognosis and more frequent MTIs; however, there was no indication that physicians incorporated this information in the fractionation scheduling.
Depth Estimation of Non-Rigid Objects for Time-Of-Flight Imaging

Depth sensing is useful for a variety of applications that range from augmented reality to robotics. Time-of- flight (TOF) cameras are appealing because they obtain dense depth measurements with low latency. However, for reasons ranging from power constraints to multi -camera interference, the frequency at which accurate depth measurements can be obtained is reduced. To address this, we propose an algorithm that uses concurrently collected images to estimate the depth of non-rigid objects without using the TOF camera. Our technique models non-rigid objects as locally rigid and uses previous depth measurements along with the optical flow of the images to estimate depth. In particular, we show how we exploit the previous depth measurements to directly estimate pose and how we integrate this with our model to estimate the depth of non-rigid objects by finding the solution to a sparse linear system. We evaluate our technique on a RGB-D dataset of deformable objects, where we estimate depth with a mean relative error of 0.37% and outperform other adapted techniques.
Searching the Grey Literature: A Handbook for Searching Reports, Working Papers, and Other Unpublished Research

Readers of Searching the Grey Literature: A Handbook for Searching Reports, Working Papers, and Other Unpublished Research should come away with a basic knowledge of the range and complexity of grey literature, as well as where it falls within the larger picture of information.