cssi/SciSciGPT-SciSciNet huggingface dataset:
A Screening Tool for Addressing the Psychiatric Needs of the Pediatric Patient in the Emergency Department

Clinical Topic: Nationally, hospitals have reported an increase in the volume of pediatric psychiatric cases presenting to the emergency department (ED). Currently, a patient who comes to this facility’s pediatric emergency department in need of psychiatric care is coded as a priority and medically screened by a physician. After all medical testing is complete, a psychiatric screener is called to evaluate the patient for service needs and/or placement. Delays in patient care for the pediatric patient may result from the psychiatric screener’s additional responsibility for adult patients in the emergency department. In addition, inpatient placement for pediatric psychiatric cases is not available at this facility, which may cause further delays while the psychiatric screener makes arrangements for transport to an accepting facility based on availability and, often, insurance carrier. To address delays in patient care for pediatric psychiatric patients, a triage-screening tool was developed to assist in rapid determination of urgency for psychiatric assistance. The purpose of the screening tool is to allow ED nurses to provide the psychiatric screener with information regarding the patient in advance so that early action can occur to facilitate timely care. This tool was adapted from Gail A. Edelsohn’s Child and Adolescent Triage Questionnaire. It allows the nurse to take the views of the patient and parent into consideration when defining the urgency of the crisis. The screening tool is comprised of 20 questions that cover history with the mental-health system, current drug use, patient concerns, school behavior, and reason for the current ED visit. Implementation: A pilot test of the screening tool began January 2005. The tool was administered randomly to patients presenting to the emergency department with psychiatric or emotional problems. All participants were capable of filling out a form and understanding the questions. A nurse practitioner explained and reviewed the tool with the patients. The answers were coded for urgency categorization based on Edelsohn’s method for classification. Outcomes: To date, the screening tool has been conducted with 10 patients. Four of the children received a psychiatric evaluation and were dispositioned within two hours of triage. Preliminary results indicate that children who require services, such as mental-health referral or scheduled outpatient screening, may experience more efficient and effective care following the use of the screening tool. Recommendations: This screening tool is relevant for the nurse caring for pediatric patients in the emergency department. Preliminary results indicate that this tool is a quick and easy method for obtaining information, classifying urgency, and assisting the psychiatric screener in determining disposition. Utilizing this screening tool may lead to improved timeliness and quality of care for the pediatric psychiatric
More Than Capacity: Alternatives for Sexual Decision Making for Individuals With Dementia

Sexual expression can be an important aspect of well being for older adults with dementia living in nursing homes. There is a tension in the nursing home, however, between ensuring autonomy of residents for sexual expression and protecting residents from harm. To alleviate this tension, nursing homes can conduct an assessment of residents' capacity for sexual consent. This article argues that although such assessments can be useful in the initial evaluation of capacity, this is a somewhat flawed approach to sexual decision making and a finding of incapacity should not necessarily preclude sexual expression. In instances where residents are found to lack capacity but continue to express interest in sexual expression, a committee approach can be utilized where residents, the nursing home, and family members can convene to advocate for residents' autonomy, dignity, and right to sexual expression while working to minimize harm. Such advocacy decisions can be based on substituted judgment, a best interest standard, or some combination of the two. Although committee decision making for sexual expression seems intrusive, it at least allows for continued discussion of the right to sexual freedom for residents in the face of significant counterbalancing forces.
Characterization of a Vortex Shaking Method for Aerosolizing Fibers

Generation of well-dispersed, well-characterized fibers is important in toxicology studies. A vortex-tube shaking method is investigated using glass fibers to characterize the generated aerosol. Controlling parameters that were studied included initial batch amounts of glass fibers, preparation of the powder (e.g., preshaking), humidity, and airflow rate. Total fiber number concentrations and aerodynamic size distributions were typically measured. The aerosol concentration is only stable for short times (t 0.3 lpm), yields an aerosol with a particle size distribution representative of the batch powder; running the vortex shaker at a lower aerosol flow rate (Q ~ 0.1 lpm) only aerosolizes the shorter fibers. These results have implications for the use of the vortex shaker as a standard aerosol generator.
White matter disease and cognitive impairment in FMR1 premutation carriers

Objective: This cross-sectional, observational study examined the role of white matter involvement in the cognitive impairment of individuals with the fragile X mental retardation 1 ( FMR1 ) premutation. Methods: Eight asymptomatic premutation carriers, 5 participants with fragile X tremor/ataxia syndrome (FXTAS), and 7 noncarrier controls were studied. The mean age of the asymptomatic premutation carriers, participants with FXTAS, and noncarrier controls was 60, 71, and 67 years, respectively. Magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) were used to examine the middle cerebellar peduncles (MCP) and the genu and splenium of the corpus callosum in relation to executive function and processing speed. MRS measures were N -acetyl aspartate/creatine (NAA/Cr) and choline/creatine, and fractional anisotropy (FA) was used for DTI. Executive function was assessed with the Behavioral Dyscontrol Scale and the Controlled Oral Word Association Test (COWAT), and processing speed with the Symbol Digit Modalities Test. Results: Among all 13 FMR1 premutation carriers, significant correlations were found between N -acetyl aspartate/creatine and choline/creatine in the MCP and COWAT scores, and between FA in the genu and performance on the Behavioral Dyscontrol Scale, COWAT, and Symbol Digit Modalities Test; a correlation was also found between FA in the splenium and COWAT performance. In all regions studied, participants with FXTAS had the lowest mean FA. Conclusion: Microstructural white matter disease as determined by MRS and DTI correlated with executive dysfunction and slowed processing speed in these FMR1 premutation carriers. Neuroimaging abnormalities in the genu and MCP suggest that disruption of white matter within frontocerebellar networks has an important role in the cognitive impairment associated with the FMR1 premutation.
Adaptive web navigation for wireless devices

Visitors who browse the web from wireless PDAs, cell phones, and pagers are frequently stymied by web interfaces optimized for desktop PCs. Simply replacing graphics with text and reformatting tables does not solve the problem, because deep link structures can still require minutes to traverse. In this paper we develop an algorithm, MINPATH, that automatically improves wireless web navigation by suggesting useful shortcut links in real time. MINPATH finds shortcuts by using a learned model of web visitor behavior to estimate the savings of shortcut links, and suggests only the few best links. We explore a variety of predictive models, including Naive Bayes mixture models and mixtures of Markov models, and report empirical evidence that MINPATH finds useful shortcuts that save substantial navigational effort.
Determination of Sulfathiazole in Honey from Medicated Honey Bee Colonies by High-Performance Liquid Chromatography on a Cyano-Amino Polar Phase

Sulfathiazole, one of four sulfonamide drugs separated on a PXS 1025 PAC chromatographic column, was measured in samples of honey collected from colonies fed medicated sugar solutions. Honey taken from locations in the brood nest contained up to 4 ppm of sulfathiazole, whereas honey in added supers contained less than 0.2 ppm, the detection limit for the method.
Surgical Treatment of a Giant Coronary Artery Aneurysm: A Modified Approach

A common surgery for giant coronary artery aneurysms includes aneurysmal ligation and coronary artery bypass grafting. We report a patient with such an aneurysm involving the left main trunk in whom the aneurysmal characteristics precluded this approach. Surgical strategy was modified and the aneurysmal sac was dissected open to define the coronary vasculature before ligating the aneurysm and completing the bypass operation.
Research University STEM Faculty Members’ Motivation to Engage in Teaching Professional Development: Building the Choir Through an Appeal to Extrinsic Motivation and Ego

This paper reports on a qualitative, grounded-theory-based study that explored the motivations of science and engineering faculty to engage in teaching professional development at a major research university. Faculty members were motivated to engage in teaching professional development due to extrinsic motivations, mainly a weakened professional ego, and sought to bring their teaching identities in better concordance with their researcher identities. The results pose a challenge to a body of research that has concluded that faculty must be intrinsically motivated to participate in teaching professional development. Results confirmed a pre-espoused theory of motivation, self-determination theory; a discussion of research literature consideration during grounded theory research is offered. A framework for motivating more faculty members at research universities to engage in teaching professional development is provided.
Decoding of triple-error-correcting b.c.h. codes

An algorithm is presented for the decoding of triple-error-correcting binary b.c.h, codes. The algorithm is particularly suitable for parallel implementation and requires no invertors.
Light microscopic immunocytochemical localization of pyruvate dehydrogenase complex in rat brain: topographical distribution and relation to cholinergic and catecholaminergic nuclei

Pyruvate dehydrogenase complex (PDHC; EC 1.2.4.1, EC 2.3.1.12 and EC 1.6.4.3) includes 3 catalytically active mitochondrial enzymes involved in the formation of cellular energy through the tricarboxylic acid cycle and in the synthesis of ACh. We sought to determine whether immunocytochemically detected PDHC was enriched in neurons of the rat CNS, and, if so, whether the perikarya containing higher levels of PDHC immunoreactivity were differentially distributed with respect to their size or location within nuclear groups containing ACh, catecholamines or other unidentified transmitters. Under the labeling conditions used in this study, the peroxidase-antiperoxidase immunoreaction product for PDHC was detectable principally in neuronal perikarya. The intensity of immunoreactivity within perikarya was variable as judged visually and by cellular, computer-assisted densitometry. In the forebrain, the most intensely labeled perikarya were seen in the medial septal nuclei, the nuclei of the diagonal band, the nuclei basalis, the dorsal and ventral striatum, and the entorhinal cortex. More caudally, intense immunoreactivity was detected in perikarya in the supraoptic hypothalamic nuclei, reticular thalamic nuclei, lateral substantia nigra, most of the tegmental nuclei, lateral nuclei of the trapezoid body, raphe pontis and obscuris, and the caudal part of the lateral reticular nuclei. In addition, many of the motor nuclei of the cranial nerves, including the dorsal motor nuclei of the vagus and the hypoglossal nuclei, and the nucleus ambiguus contained perikarya with intense PDHC labeling. Densitometry revealed no differences in intensity of immunoreactivity in soma of varying sizes. However, the intensity of neuronal labeling for PDHC was significantly greater in several nuclear groups that were shown in adjacent sections to contain cholinergic, but not catecholaminergic, enzymes. In contrast, the primary olfactory cortex, pyramidal cell layer of the regio inferior of hippocampus, and the Purkinje cell layer of the cerebellum were regions having perikarya with intense PDHC immunoreactivity but lacking both the synthetic and the degradative enzymes for ACh. These results provide the first morphological evidence that PDHC, a general metabolic enzyme complex, is enriched in selective perikarya that are heterogeneously distributed in brain and are especially abundant in many of the regions containing cholinergic neurons. The heterogeneity of PDHC immunoreactivity suggests that certain cholinergic as well as noncholinergic nuclei may be selectively vulnerable to mitochondrial diseases involving pyruvate utilization.
Cancer Previval and the Theatrical Fact

Healthy women who are at hereditary risk for developing breast and ovarian cancer are surgically enacting the disease in material registers on their flesh in order to survive cancer in advance. In this practice of "previval," the disease becomes itself, or gains biomedical substance, through its own theatrical gesture.
Oxidative Stress Affects the Integrin-Linked Kinase Signaling Pathway After Transient Focal Cerebral Ischemia

Background and Purpose— The integrin-linked kinase (ILK) signaling pathway contributes to regulation of cellular adhesion, migration, and differentiation, and to apoptotic cell death after a variety of cell death stimuli. We have reported that overexpression of copper/zinc superoxide dismutase (SOD1) reduces apoptotic cell death by promoting the phosphatidylinositol 3-kinase (PI3-K)/Akt survival pathway after transient focal cerebral ischemia (tFCI). However, the role of the ILK pathway after tFCI and the role of oxygen free radicals in regulation of apoptosis remain unclear. Methods— To clarify these issues, we used an in vivo tFCI model with SOD1 transgenic mice and wild-type mice. We administered the PI3-K inhibitor, LY294002, into mouse brains after tFCI and examined the role of PI3-K in the ILK pathway and expression of the ILK/Akt complex by immunohistochemistry, Western blot analysis, and coimmunoprecipitation. Results— A transient increase in ILK was detected early after tFCI and was prevented by ...
Gifted and the "Zone of Proximal Development.".

Identification of the gifted student is problematic. Prescription, the matching of student needs with program services, is perhaps even more precarious. To optimize potential and maximize achieveme...
RAD53 Regulates DBF4 Independently of Checkpoint Function in Saccharomyces cerevisiae

The Cdc7p and Dbf4p proteins form an active kinase complex in Saccharomyces cerevisiae that is essential for the initiation of DNA replication. A genetic screen for mutations that are lethal in combination with cdc7-1 led to the isolation of seven lsd (lethal with seven defect) complementation groups. The lsd7 complementation group contained two temperature-sensitive dbf4 alleles. The lsd1 complementation group contained a new allele of RAD53, which was designated rad53-31. RAD53 encodes an essential protein kinase that is required for the activation of DNA damage and DNA replication checkpoint pathways, and that is implicated as a positive regulator of S phase. Unlike other RAD53 alleles, we demonstrate that the rad53-31 allele retains an intact checkpoint function. Thus, the checkpoint function and the DNA replication function of RAD53 can be functionally separated. The activation of DNA replication through RAD53 most likely occurs through DBF4. Two-hybrid analysis indicates that the Rad53p protein binds to Dbf4p. Furthermore, the steady-state level of DBF4 message and Dbf4p protein is reduced in several rad53 mutant strains, indicating that RAD53 positively regulates DBF4. These results suggest that two different functions of the cell cycle, initiation of DNA replication and the checkpoint function, can be coordinately regulated through the common intermediate RAD53.
Rituximab Selectively Suppresses Specific Islet Antibodies

OBJECTIVE The TrialNet Study Group evaluated rituximab, a B-cell–depleting monoclonal antibody, for its effect in new-onset patients with type 1A diabetes. Rituximab decreased the loss of C-peptide over the first year of follow-up and markedly depleted B-lymphocytes for 6 months after administration. This article analyzes the specific effect of rituximab on multiple islet autoantibodies. RESEARCH DESIGN AND METHODS A total of 87 patients between the ages of 8 and 40 years received either rituximab or a placebo infusion weekly for four doses close to the onset of diabetes. Autoantibodies to insulin (IAAs), GAD65 (GADAs), insulinoma-associated protein 2 (IA2As), and ZnT8 (ZnT8As) were measured with radioimmunoassays. The primary outcome for this autoantibody analysis was the mean level of autoantibodies during follow-up. RESULTS Rituximab markedly suppressed IAAs compared with the placebo injection but had a much smaller effect on GADAs, IA2As, and ZnT8As. A total of 40% (19 of 48) of rituximab-treated patients who were IAA positive became IAA negative versus 0 of 29 placebo-treated patients ( P n = 6) treated within 50 days of diabetes, IAAs were markedly suppressed by rituximab in all patients for 1 year and for four patients as long as 3 years despite continuing insulin therapy. Independent of rituximab treatment, the mean level of IAAs at study entry was markedly lower ( P = 0.035) for patients who maintained C-peptide levels during the first year of follow-up in both rituximab-treated and placebo groups. CONCLUSIONS A single course of rituximab differentially suppresses IAAs, clearly blocking IAAs for >1 year in insulin-treated patients. For the patients receiving insulin for >2 weeks prior to rituximab administration, we cannot assess whether rituximab not only blocks the acquisition of insulin antibodies induced by insulin administration and/or also suppresses preformed insulin autoantibodies. Studies in prediabetic non–insulin-treated patients will likely be needed to evaluate the specific effects of rituximab on levels of IAAs.
Obstructive Renal Disease in Cancer Patients

Urinary tract obstruction (UTO) is a common complication in cancer patients especially in those with urogenital cancers. Occasionally obstructions are diagnosed late in the course of disease. Early detection and correction of any significant underlying obstruction will help preserve the renal function and help minimize cancer therapy related complications. In general, the mechanisms of UTO are similar in nature to the general population; however, there are some unique etiologies such as retroperitoneal lymphadenopathy and fibrosis and BK virus-associated ureteral stenosis. Cancer therapy by mitigating lymphadenopathy and infiltrative process as well as by placing stents and percutaneous nephrostomy (PCN) when indicated provides relief. Etiology of UTO include extension of local tumors to urinary tract, blood clots, deposition of crystals, secondary retroperitoneal fibrosis, bladder outlet obstruction from bladder cancer, and BK virus ureteral stenosis. The obstruction can be unilateral, bilateral, partial, or complete. In addition, use of urinary diversion procedures needs to be individualized in the cancer population based on the etiology, prognosis, and quality of life.
Maternal-fetal effects of propiomazine-meperidine analgesia

Abstract 1. This combination of meperidine-propiomazine proved to be an effective, safe medication during labor for both mother and infant. 2. Other effects demonstrating the effect of the addition of propiomazine to meperidine are: significantly greater analgesia, sedation and alleviation of anxiety; more rapid onset of action; no prolongation of sedative effect of propiomazine over analgesic effect of meperidine, allowing remedication with the initial ratio; no hyperactive, irrational response as reported with other phenothiazines. 3. There was no incidence of hypotension; transient hypertension occurred in 3.25 per cent of patients who were normotensive prior to medication. 4. Thirty per cent of hypertensive patients developed further but transient rise in pressure following medication. No untoward effects were noted from this rise. 5. One dose was adequate in 71.5 per cent of patients in spite of shorter duration of action. Of those requiring a second dose, 80 per cent were primigravidas. 6. The amnesic effect was not pronounced. 7. Meperidine levels were demonstrated in both maternal and fetal blood, again demonstrating placental transfer of this molecule. 8. There were no serious complications in patients treated with the combination.
Fatty acids of RBC ghosts, liver mitochondria and microsomes of cold-acclimated hamsters.

SummaryWhen hamsters were exposed to cold, the relative percentage of various fatty acids in mitochondrial and microsomal membranes of liver cells changed. In mitochondria, the percentage of oleic acid increases, and in microsomes the percentages of oleic increased and palmitic acid decreased. These findings are in contrast to results of earlier studies on whole livers, which showed that under similar conditions, the percentage of stearic acid decreases. There were no changes in fatty acid percentage composition in RBC ghost cells after 5-9 weeks of exposure. These studies also indicate that there were striking differences in the fatty acid composition of membranes of various organelles in the cell.
DETECTION OF M PROTEIN IN COLONIES OF STREPTOCOCCAL L FORMS BY IMMUNOFLUORESCENCE.

SummaryM protein was detected in growing L-form colonies of Group A streptococci by an immunofluorescent technique which employs type-specific fluorescein-la-beled antibody. The type-specificity of the FA-staining reactions exhibited by the L forms was confirmed by parallel precipitin studies. These data suggest the feasibility of identifying the L-form colonies of Group A streptococci by detecting the M protein with the FA method.
Does a Negative Emergency Celiotomy Exclude the Possibility of Significant Diaphragmatic Injury? A Case Report and Review of the Literature.

Introduction: Diaphragmatic rupture (DR) is an uncommon, potentially serious complication following blunt or penetrating ab- dominal trauma. Even with a high index of suspicion, the diagnosis of DR can easily be missed for a long period post injury. Delayed or missed diagnosis (delayed diagnosis of diaphragmatic rupture (DDDR)) and delayed diaphragmatic rupture (DDR) are possible explanations in cases where the initial operative exploration fails to show the diaphragmatic damage. Case Presentation: Here we present a patient with suspected DR that was not seen on initial open abdominal exploration, but was suggested by subsequent serial imaging. This injury was ultimately identified on laparoscopic exploration. The procedure was converted to open (celiotomy) due to poor tolerance of the pneumoperitoneum required for laparoscopy, and the laceration was primarily repaired. We propose that DDR and DDDR be considered as a dierential diagnosis in patients with a previous thoraco- abdominal trauma when presenting with radiologic/clinical signs suspicious for DR, even when the immediate post traumatic ex- ploration failed to demonstrate a DR. Conclusions: A high index of suspicion is essential for early detection of DDR and DDDR. Patients with high impact injuries or surrounding organ damage should be followed with serial clinical examinations, follow-up radiologic assessments, and even re- exploration in situations highly suspicious for diaphragmatic injuries.
Absorption of Near UV Light by HNO3/NO3– on Sapphire Surfaces

We have determined absorption of the near UV light (290–345 nm) by nitric acid (HNO3) deposition on sapphire window surfaces as a function of the HNO3 pressure, by using Brewster angle cavity ring-down spectroscopy. Apparent monolayer HNO3 surface absorption cross sections have been obtained; they range between (1.7 ± 1.1) × 10–19 and (0.29 ± 0.03) × 10–19 cm2/molecule. When nitric acid cross section values on sapphire surfaces were divided by those on fused silica surfaces for which only molecular HNO3 adsorption was reported, a new absorption band appeared in the 320–345 nm region. The shape of this absorption band is similar to that reported for surface nitrate (NO3–) at quartz/water interfaces, but is red-shifted by about 10 nm. Our study suggests that a small percentage (<7%) of adsorbed HNO3 formed by HNO3 deposition on sapphire surfaces is dissociated into surface nitrate on the time scale of about 5–7 min. Background transmission changes in the 320–350 nm region after exposing clean sapphire surfa...
Evolutionary computation in the undergraduate curriculum

In this paper we discuss evolutionary algorithms and the role they play in solving difficult problems. With the rising importance of evolutionary methods in the application of computer programming, a case can be made that a module addressing these methods should be included in a course that covers computer algorithms. First we review the history of evolutionary algorithms (EAs) and their current use, then we describe the EA method. We end with an outline of a module on EAs in the undergraduate course on algorithms.
Reactor physics parameters of alternate fueled fast breeder reactor core designs

Nuclear nonproliferation considerations have resulted in renewed interest in the thorium fuel cycle. Reactor physics parameters of a typical 1200-MW(electric) fast breeder reactor design were compa...
Pre-exercise anxiety and the anxiolytic responses to acute bouts of self-selected and prescribed intensity resistance exercise.

Background The present investigation examined the state anxiety responses to acute bouts of self selected and prescribed intensity resistance exercise (RE). College age women (n=19) currently enrolled in a beginning weight training class were recruited to participate. Methods Participants completed 3 randomly assigned, counterbalanced conditions of self-selected intensity RE, prescribed intensity RE (75% of 1RM), and quiet rest control. Assessments of state anxiety (SA) were obtained prior to as well as 5, 20, 60, and 120 min following each condition. Ratings of perceived exertion (RPE) were assessed within both RE conditions. Results RPE was found to be higher during prescribed intensity RE. To examine the role of pre-exercise anxiety level on SA responses, baseline values in each condition were stratified into high and low groups. Analyses revealed that, irrespective of intensity, SA was significantly reduced following both self-selected and prescribed RE conditions within the high baseline SA group. Conversely, reductions in SA only emerged 60 and 120 min following the selfselected RE condition in the low baseline SA group. Conclusions It is concluded that the SA responses to acute RE are influenced by baseline anxiety level and the relative intensity of the bout. Results suggest that reductions in SA are observed following acute RE independent of the intensity of exercise in the presence of high baseline SA values whereas reductions are only exhibited following less intense bouts of RE when low baseline SA levels are evident.
Outpatient Management of Burns

Currently over 90 % of the thermally injured patients receive their care in an outpatient setting and this percentage is increasing. Though these patients do not require intensive therapies, they still require monitoring of their healing wounds, adequate pain control, appropriate assessment of their emotional healing and societal reintegration. Medical care in the USA is in a time of great change where we are being asked to reduce medical costs and expensive inpatient care, while maintaining and even improving the quality of the care we deliver. Burn centers, which have been successful in building great inpatient burn centers, will need spend time building and resourcing robust outpatient clinics and begin to monitoring outpatient patient outcomes.
Central Representation of Itch

Chronic itch is multidimensional phenomenon associated with emotional and cognitive aspects of suffering that causes the urge to scratch. The brain is the final terminal to receive itch-related neural signals from the body and to process them. Thus, it is important to better understand the mechanism of itch and its behavioral response of scratching in the brain. Brain imaging studies using positron emission tomography, functional MRI, electroencephalography, and magnetoencephalography have been conducted to understand the cerebral mechanism of itch mainly in healthy subjects using experimental itch models. Several brain imaging studies have investigated this mechanism in chronic itch patients to better understand the pathophysiology of chronic itch in the central nervous system. Pharmacological functional MRI studies add to our understanding of drug-effects on brain systems. Recently, this technique was used to investigate how a kappa opioid drug butoprhanol, modulates the processing of itch in the brain. Other promising treatments targeting the brain such as non-invasive transcranial Direct Current Stimulation that has been used for treatments of chronic pain has been reported for itch relief. In this chapter, we review the current progress in neuroimaging research of itch and scratch and its treatments.
Direct RF to optical link based on film bulk acoustic wave resonators (FBAR)

We demonstrate conversion of a 10GHz radio frequency signal directly to fiber optics. A Fabry-Perot cavity formed between a fiber tip and an AlN-film acoustic resonator electrode enables resonantly enhanced phase modulation of back-reflected light.
Intraoperative questioning to advance higher-order thinking

Abstract Background The type of question asked elicits a particular response. The purpose of this study was to determine what types and levels of questions were asked in the operating room. These insights are important for understanding how questions are used to advance learners. Methods 12 laparoscopic cholecystectomy operations were observed and recorded at a single institution. Intraoperative questions asked by faculty were transcribed for all cases. Using revised Bloom's taxonomy, questions were classified into one of 5 levels: (1) remembering , (2) understanding , (3) applying , (4) analyzing , (5) evaluating . Results 141 questions were asked by faculty and ranged from 0 to 34 questions per case. Classification of questions showed there were 43 remembering , 29 understanding , 47 applying, 13 analyzing , and 8 evaluating questions asked. Conclusions Questioning was predominately classified at lower-order and mid-level thinking skills (120/141). Integrating intraoperative questions at higher-order levels has the potential to guide trainees into progressively complex thinking and decision making.
Design a robust power system stabilizer on SMIB using Lyapunov theory

This paper proposes a robust power system stabilizer (PSS) using Lyapunov Stability theory introduced in Optimization & Control in Power System class at University of South Florida. This research examines the robustness of the novel PSS in the synchronous generator connected to an infinite bus (SMIB) system under multiple operation conditions. After deriving the state space matrices of the linear model of the system, the gains of robust PSS are estimated using Lyapunov function in the linear matrix inequality (LMI). The model analyzed in this paper is an electromagnetic model with automatic voltage regulator (EMT+AVR). Then, EMT+AVR model with the robust PSS is analyzed and compared with the conventional PSS. In the simulation part, the nonlinear simulation is conducted in MATLAB/Simulink to compare the conventional PSS and novel PSS.
The Mediating Effect of Self-Control on Parenting and Delinquency: A Gendered Approach With a Multinational Sample:

This study aims to clarify the relationships between parenting techniques, low self-control, and juvenile delinquency in Gottfredson and Hirschi's general theory of crime while controlling for alternative explanations of delinquency. We relied on a sample of 35,511 adolescent students from 31 countries from the International Self-Report Delinquency 2 Study. Results indicate that parenting exhibits a direct effect on adolescents' violence perpetration and property offending, and that while self-control weakens the strength of this relationship, it fails to fully mediate it. Males reported lower levels of self-control, exposure to poorer parenting techniques, and higher rates of violence perpetration and property offending. The relationship between parenting, self-control, and juvenile delinquency was similar for females and males. These results provide evidence that parenting has important implications for adolescents' involvement in delinquency above and beyond its influence on their level of self-control.
Realism and the Origin of the Genetic Code

With the development of the proteinoid microsphere in the laboratories of Dr. Sidney W. Fox, whose own origins we honor in this book, a convincing model of preliving particles leading to an actual early protobiont has been created. Not only was this model originated in those laboratories but subsequently was perfected, through persistent experimental and constructionistic approaches, to the point where first generations--and even partial second generations--have been produced through self-replicatory processes (Fox, 1968, 1969). In fact, it would appear that little of major proportions remains to be elaborated further on this representation of a possible earliest stage in life’s origin on this earth, although a number of the preceding papers in this volume show the need for lesser details to be added.
Post-transcriptional regulation of Bax and Bak protein expression in rituximab and chemotherapy resistant B-cell non-Hodgkin’s lymphoma (NHL) cells

4085 The balance between pro-apoptotic (Bax,Bak) and anti-apoptotic (Bcl-2, Bcl-xL, Mcl-1) Bcl-2 family proteins is essential for the maintenance of B-cell homeostasis. Disruption of this critical balance occurs in the majority of B-cell neoplasms. Clinically, high Bcl-2/Bak and Bcl-2/Bax ratios have been associated with decreased median survival (7.3 years and 3.8 years, respectively) in follicular lymphoma patients 1 . Recent work in mouse embryonic fibroblasts deficient for the multi-domain pro-apoptotic Bcl-2 family proteins Bax and Bak has shown that they are essential for induction of cell death following apoptotic stimuli that act through the mitochondrial (intrinsic) pathway 2 . The vast majority of clinically available anti-neoplastic agents, including rituximab, are known to induce cell death via this pathway and therefore likely rely on Bax and/or Bak to exert their anti-tumor effects. Alteration in expression of Bax and/or Bak could therefore underlie acquired resistance to chemotherapy and/or rituximab in NHL patients. We have focused on studying the mechanisms of resistance to rituximab and developed several rituximab-resistant cell lines (RRCL). RRCL were generated by exposing Raji, SU-DHL-4 and RL cells to escalating doses of rituximab human serum and subsequently cloning by limited dilution. Interestingly, we demonstrated that RRCL are resistant to various chemotherapy agents. In our present work we studied the intrinsic apoptotic pathway in an attempt to explain shared mechanisms of resistance to chemotherapy and rituximab. We found that RRCL have dramatically reduced levels of both Bax and Bak proteins by Western blot while levels of Bcl-2, Bcl-xL and Mcl-1 protein were comparable to parental cells. Additionally, Bax and Bak were only detected in sensitive parental cells following a short (30’) 35 S-methionine label of parental or RRCL. Interestingly, quantitative real-time PCR revealed that the level of Bax and BAK1 message is equivalent when comparing RRCL to parental cells. In summary our data suggest that Bax and Bak protein expression in RRCL is regulated post-transcriptionally and may be regulated at the level of translation. Currently we are attempting to determine whether post-transcriptional regulation of Bax and Bak occurs in primary non-Hodgkin’s lymphoma patient samples and to further define the mechanism(s) underlying the down-regulation of Bax and Bak seen in RRCL. 1 Wei M.C. et al . 2001 Science 292(5517):727–30. 2 Gulmann C., et al . 2005. Clin Cancer Res. 11(16):5847–55.
Child welfare workers' sexism and beliefs about father involvement

Abstract Research over the last few decades has consistently found that fathers are not routinely included in the provision of child welfare services. The current study examined whether ambivalent sexism on the part of child welfare workers was related to their beliefs about involving fathers. Ambivalent sexism theory posits that gender stereotypes include subjectively positive beliefs in addition to hostile beliefs that both serve to perpetuate patriarchal systems. Participants (N = 490) were currently front-line child welfare workers in the United States who completed an online survey assessing ambivalent sexism and beliefs about father involvement in child welfare cases. Ambivalent sexism was assessed using the Ambivalent Sexism Inventory and the Ambivalence Toward Men Inventory. The Dakota Father Friendly Assessment was modified to assess beliefs about father involvement in child welfare. Latent class analysis was used to empirically derive four sexism profiles. Results indicated that participants with profiles suggesting less sexist beliefs had more positive attitudes about father involvement and had a lower preference for working solely with mothers. Sexism profile was not related to participants' stated father involvement behaviors such as conducting home visits when fathers are present, including fathers in case planning discussions, and recruiting fathers or paternal relatives as placement options. Implications for social work and child welfare practice include developing training that increases knowledge of fathers' importance and increases workers' comfort in providing services to men.
Competition and Synergy Between Prochlorococcus and Synechococcus Under Ocean Acidification Conditions

Anthropogenic CO2 emissions are projected to lower the pH of the open ocean by 0.2 to 0.3 units over the next century. Laboratory experiments show that different phytoplankton taxa exhibit a wide variety of responses, with some strains having higher fitness under projected future conditions, and others being negatively impacted. Previous studies have suggested that Prochlorococcus and Synechococcus, the numerically dominant picophytoplankton in the oceans, have very different responses to elevated CO2 that may result in a dramatic shift in their relative abundances in future oceans. Here we show that these two genera experience faster exponential growth rates under future CO2 conditions, similar to most other cyanobacteria that have been studied. However, Prochlorococcus strains have significantly lower realized growth rates due to more extreme lag periods after exposure to fresh culture media. Surprisingly, however, Synechococcus was unable to outcompete Prochlorococcus in co-culture at elevated CO2. Under these conditions, Prochlorococcus9 poor response to elevated CO2 disappeared, and it showed negative frequency dependence in its relative fitness compared to Synechococcus, with a significant fitness advantage when it was initially rare. Moreover, both Synechococcus and Prochlorococcus had faster growth rates in co-culture with each other than either had in unialgal culture. We speculate that this negative frequency dependence is an outgrowth of reductive Black Queen evolution operating on both taxa that has resulted in a passively mutualistic relationship analogous to that connecting Prochlorococcus with the "helper" heterotrophic microbes in its environment.
Bridging the gap to effective feedback in residency training: perceptions of trainees and teachers.

Clinical feedback is an important part of residency training, yet literature suggests this complex interaction is not completely understood. In particular, little is known about what resident versus attending physicians expect as feedback. This study investigates this gap in knowledge by examining differences in interactions that residents and attendings view as feedback. Surveys containing sample clinical feedback scenarios were distributed to residents and attending physicians in emergency medicine and general surgery at a large academic medical center. Respondents were asked to decide whether useful feedback was provided in each scenario, and responses were compared between the two groups. Continuous features were summarized with medians, interquartile ranges (IQRs), and ranges; categorical features were summarized with frequency counts and percentages. Comparisons of features between residents and attendings were evaluated using Wilcoxon rank sum, chi-square, and Fisher exact tests. Statistical analyses were performed using version 9.4 of the SAS software package (SAS Institute, Inc.; Cary, NC). All tests were two-sided and p-values < 0.05 were considered statistically significant. Seventy-two individuals responded to the survey out of approximately 110 invitations sent (65%), including 35 (49%) residents and 37 (51%) attendings. Of 35 residents, 31 indicated their level of training, which included 13 (42%) PGY-1, 9 (29%) PGY-2, 6 (19%) PGY-3, and 3 (10%) PGY-4, respectively. Of 37 attendings, 34 indicated the number of years since completion of residency or last fellowship, at a median of 9 years (IQR 4–14; range 1–31). No significant difference was found in residents’ and attendings’ perceptions of what constituted feedback in the sample scenarios. While this study did not find a statistical difference in perception of feedback between residents and attendings, additional factors should be considered when investigating perceived feedback deficiencies. Further research is needed to better understand and improve the clinical feedback process.
Urban growth and climate adaptation

Urban development induces local warming in addition to climate change. New research shows that urban growth, climate change and urban adaptation interact nonlinearly and diurnally.
Comprehensive Understandings of Rare Earth Element (REE) Speciation in Coal Fly Ashes and Implication for REE Extractability

In recent years, recovery of rare earth elements (REEs) from coal fly ashes (CFAs) has been considered as a promising resource recovery option. Yet, quantitative information on REE speciation in CFAs and its correlation with REE extractability are not well established. This study systematically investigated the REE speciation-extractability relationship in four representative CFA samples by employing multiple analytical and spectroscopic techniques across the micro to bulk scale and in combination with thermodynamic calculations. A range of REE-bearing phases are identified, such as REE oxides, REE phosphates, apatite, zircon, and REE-bearing glass phase. REEs can occur as discrete particles, as particles encapsulated in the glass phase, or distribute throughout the glass phase. Although certain discrepancies exist on the REE speciation quantified by X-ray adsorption spectroscopy and acid leaching due to intrinsic limitations of each method, both approaches show significant fractions of REE oxides, REE phosphates, apatite, and REE-bearing Fe oxides. This study contributes to an in-depth understanding of the REE speciation-distribution-extractability relationship in CFAs and can help identify uncertainties associated with the quantification of REE speciation. It also provides a general methodology for future studies on REE speciation in complex environmental samples and a knowledge basis for the development of effective REE recovery techniques.
Active-site differences between substrate-free and ritonavir-bound cytochrome P450 (CYP) 3A5 reveal plasticity differences between CYP3A5 and CYP3A4.

Cytochrome P450 (CYP) 3A4 is a major contributor to hepatic drug and xenobiotic metabolism in human adults. The related enzyme CYP3A5 is also expressed in adult liver and has broader age and tissue distributions. However, CYP3A5 expression is low in most Caucasians because of the prevalence of an allele that leads to an incorrectly spliced mRNA and premature termination of translation. When expressed, CYP3A5 expands metabolic capabilities and can augment CYP3A4-mediated drug metabolism, thereby reducing drug efficacy and potentially requiring dose adjustments. The extensive role of CYP3A4 in drug metabolism reflects in part the plasticity of the substrate-free enzyme to enlarge its active site and accommodate very large substrates. We have previously shown that the structure of the CYP3A5–ritonavir complex differs substantially from that of the CYP3A4–ritonavir complex. To better understand whether these differences are conserved in other CYP3A5 structures and how they relate to differential plasticity, we determined the X-ray crystallographic structure of the CYP3A5 substrate-free complex to 2.20 A resolution. We observed that this structure exhibits a much larger active site than substrate-free CYP3A4 and displays an open substrate access channel. This reflected in part a lower trajectory of the helix F–F′ connector in CYP3A4 and more extensive π–CH interactions between phenylalanine residues forming the roof of the active-site cavity than in CYP3A5. Comparison with the CYP3A5–ritonavir complex confirmed conserved CYP3A5 structural features and indicated differences in plasticity between CYP3A4 and CYP3A5 that favor alternative ritonavir conformations.
Distinctive vowel length: duration vs. spectrum in Thai

Many languages are described as having a phonological distinction of length in vowels or consonants or even both. If the term is to be taken literally, we would expect to find that the underlying mechanism is control of the relative durations of the articulations for the phonemes in contrast. In languages with short and long vowels, however, it is often observed that short and long counterparts have somewhat different vowel qualities. Previous work on the vowels of Central Thai has shown that relative duration is a sufficient acoustic cue for the length distinction. Since, however, short vowels in portions of the vowel space tend to be more open, we have sought to learn how much of the perceptual burden is borne by relative duration, the major physical correlate of length, and how much by the spectrum (formant pattern), the major physical correlate of vowel quality. We have incrementally lengthened original short vowels and shortened original long vowels in minimal pairs of words embedded in sentences, thus preserving the spectral differences. The stimuli were played to native speakers for identification. The results show that the dominant cue is relative duration; however, for all the vowel pairs, the category boundary is influenced by spectral differences with, perhaps, some effect of the timing of the context as well.
A Case of Pasteurella Meningitis with c3 Osteomyelitis Complicated by Oligoarticular Hemarthroses in a 5-month-old

Case Report: A 5-month-old previously healthy, adopted African-American female presented to her pediatrician with a one-week history of fever, increased fussiness, and diarrhea. Exam revealed bulging fontanelle concerning for meningitis. She was transferred to the Emergency Department (ED) for sepsis evaluation. Her initial exam revealed an ill-appearing, but non-toxic infant with tachycardia, grunting and tachypnea. Anterior fontanelle was bulging, but non-pulsatile. Initial work up revealed a CBC with leukocytosis and neutrophil predominance along with normocytic anemia. CSF studies were concerning for …