cssi/SciSciGPT-SciSciNet huggingface dataset:
Fractional anisotropy to quantify cervical spondylotic myelopathy severity.

Background A number of clinical tools exist for measuring the severity of cervical spondylotic myelopathy (CSM). Several studies have recently described the use of non-invasive imaging biomarkers to assess severity of disease. These imaging markers may provide an additional tool to measure disease progression and represent a surrogate marker of response to therapy. Correlating these imaging biomarkers with clinical quantitative measures is critical for accurate therapeutic stratification and quantification of axonal injury. Methods Fourteen patients and seven healthy control subjects were enrolled. Patients were classified as mildly (7) or moderately (7) impaired based on Modified Japanese Orthopedic Association Scale. All patients underwent diffusion tensor imaging (DTI) and diffusion basis spectrum imaging (DBSI) analyses. In addition to standard neurological examination, all participants underwent 30-m Walking Test, 9-hole Peg Test (9HPT), grip strength, key pinch, and vibration sensation thresholds in the index finger and great toe. Differences in assessment scores between controls, mild and moderate CSM patients were correlated with DTI and DBSI derived fractional anisotropy (FA). Results Clinically, 30-meter walking times were significantly longer in the moderately impaired group than in the control group. Maximum 9HPT times were significantly longer in both the mildly and moderately impaired groups as compared to normal controls. Scores on great toe vibration sensation thresholds were lower in the mildly impaired and moderately impaired groups as compared to controls. We found no clear evidence for any differences in minimum grip strength, minimum key pinch, or index finger vibration sensation thresholds. There were moderately strong associations between DTI and DBSI FA values and 30-meter walking times and 9HPT. Conclusions The 30-m Walking Test and 9HPT were both moderately to strongly associated with DTI/DBSI FA values. FA may represent an additional measure to help differentiate and stratify patients with mild or moderate CSM.
Increases in resident and faculty computing skills between 1998 and 2001.

BACKGROUND AND OBJECTIVES Following a 1998 survey, we hypothesized that family practice residents would soon demand more advanced informatics and computer training than faculty could provide. We repeated the survey in 2001 to test our hypothesis. METHODS We surveyed 97 first-year medical students, 46 family practice residents, and 18 family medicine faculty at our institution. We compared responses among groups and within groups since 1998. RESULTS Significantly more respondents owned a computer in 2001 than in 1998. E-mail and Internet use increased dramatically for all groups. Students and faculty had significantly greater confidence in their general computer abilities than residents did in 2001, but third-year residents' confidence had increased significantly since 1998. Respondents cited inadequate computer resources as the most important barrier to effective computer use. CONCLUSIONS Resident and faculty self-assessed computer skills have increased substantially at our program since 1998. These increases appear due to the current ubiquity of computers in society and improvements in device functionality and ease of use rather than curricular activities. Few residents and faculty need the basic computer training recommended in curricular guidelines. Residency programs should maintain up-to-date computer resources and consider providing selective advanced computer skills training.
Enrico Bombieri: On Intuition

This chapter discusses the role of intuition in mathematics: what it is, how to get it, and how to use it. After giving a famous example in number theory involving Bombieri, a proof contributed by reader Colin Reid to refute the previous chapter’s intuition about the solving power of finite groups is presented and assessed.
DQw4: A New Allele of HLA-DQ

With the definition of the alleles DQw1, 2, and 3, there remains a high proportion of DQ-“blank” haplotypes (24% Caucasian, (9th Workshop central analysis). This was particularly so in haplotypes such as DRw8 (79%) and DR3 (42%). The antibody HU46, (9W921, 10W3101) contributed by Aizawa et al. (1,2), was found to define a new DQ specificity associated with DR4, Dw15, and DRw8. Recently an alloantiserum recognizing this antigen has also been described (3).
Aircraft Meteorological Instruments

The first scheduled weather flights were made in the early 1930’s and were essentially vertical soundings. The airplanes carried simple meteorographs which re­corded temperature, pressure, and humidity in much the same manner as the balloon-borne meteorographs of that period. Radiosondes being as yet undeveloped, the use of airplanes was the most practical method of obtaining vertical measurements promptly for fore­casting purposes. At present the airplane, with its greater speed and cruising range, is more commonly used for measurements aloft along a chosen horizontal line, and it is for flights of this type that most instru­mentation is now designed.
What we're trying to solve: the back and forth of engaged interdisciplinary inquiry

Interdisciplinary research assumes that teams of highly specialized scientists develop new knowledge by bridging their respective horizons. Nurse educators preparing nursing doctoral students to conduct interdisciplinary research need insight into how members of interdisciplinary research teams experience knowledge horizons in these complex contexts. Based on the work of the philosopher Bernard Lonergan, this pilot study uses Transcendental Method for Research with Human Subjects to explore interdisciplinary researchers' experiences with and attitudes toward interdisciplinary research. Results reveal the overarching conceptual category of "engaged interdisciplinary inquiry" which includes six themes: (i) valuing interdisciplinary engagement; (ii) direct engagement; (iii) interior engagement; (iv) disengagement; (v) facilitated engagement and (vi) engaged researcher development. Results also suggest engagement depends on vigorous "back and forth", or dialogue, with self and others, and demonstrate the study method is fruitful for cognitive inquiry. This pilot supports expanded study to inform preparation for and conduct of interdisciplinary research involving nurses and raises important questions about how the trend toward interdisciplinary research affects nursing science.
The carbon mainframe structure of cis-trans-1,3-difluoroacetone

Abstract The carbon-13 backbone structure of 1,3-difluoroacetone has been obtained and reported for the first time. This was achieved through the collection of singly substituted 13 C isotopologue rotational spectra at each carbon position. The rotational constants for each isotopologue have been determined and are reported for the first time. Kraitchman coordinates and second moment analysis verify the structure determined by previous literature studies and are presented.
Theory of interval traveltime parameter estimation in layered anisotropic media

ABSTRACTMoveout approximations for reflection traveltimes are typically based on a truncated Taylor expansion of traveltime squared around the zero offset. The fourth-order Taylor expansion involves normal moveout velocities and quartic coefficients. We have derived general expressions for layer-stripping second- and fourth-order parameters in horizontally layered anisotropic strata and specified them for two important cases: horizontally stacked aligned orthorhombic layers and azimuthally rotated orthorhombic layers. In the first of these cases, the formula involving the out-of-symmetry-plane quartic coefficients has a simple functional form and possesses some similarity to the previously known formulas corresponding to the 2D in-symmetry-plane counterparts in vertically transversely isotropic (VTI) media. The error of approximating effective parameters by using approximate VTI formulas can be significant in comparison with the exact formulas that we have derived. We have proposed a framework for derivin...
A 2–15-GHz Accurate Built-in-Self-Test System for Wideband Phased Arrays Using Self-Correcting Eight-State $I/Q$ Mixers

A built-in-self-test (BIST) system for wideband phase arrays channels is presented. The BIST is implemented using an on-chip in-phase/quadrature ( $I/Q$ ) receiver with an integrated ring oscillator that provides both the channel test signal and the mixer local oscillator (LO). The BIST achieves wideband accuracy for relative phase and gain measurements at 2–15 GHz with a one-time self-correction algorithm with eight LO phases. The sequential algorithm determines the $I/Q$ errors, such as dc offset, gain and phase imbalances from the $I/Q$ outputs resulting from different LO phase states. An rms power detector network is also implemented for absolute gain measurements. The BIST can operate at rates >1 MHz (less than 1- $\mu \text{s}$ sampling time) with signal-to-noise ratio greater than 50 dB and provides measurements that agree well with the vector network analyzer S-parameter data over a wide frequency range. To the best of our knowledge, this is the first implementation of high accuracy wideband BIST system for phased-array channels.
Speech quality assessment using digital watermarking

Speech quality evaluation is a very important research topic. The mean opinion score (MOS) is reliable but the listening test is very expensive, time consuming, and sometimes impractical. The existing objective quality assessment methods require either the original speech or complicated computation model, which makes some applications of quality evaluation impossible. We propose to use digital audio watermarking to evaluate the quality of speech. Our method does not need original signal or computation model. The experimental results show that the method yields accurate quality scores that are very close to the results of PESQ.
Assessing changes in the physico-chemical properties and fluoride adsorption capacity of activated alumina under varied conditions

Abstract Adsorption using activated alumina is a simple method for removing fluoride from drinking water, but to be cost effective the adsorption capacity must be high and effective long-term. The intent of this study was to assess changes in its adsorption capacity under varied conditions. This was determined by evaluating the physico-chemical properties, surface charge, and fluoride (F−) adsorption capacity and rate of activated alumina under conditions such as hydration period, particle size, and slow vs. fast titrations. X-ray diffraction and scanning electron microscopy analyses show that the mineralogy of activated alumina transformed to boehmite, then bayerite with hydration period and a corresponding reduction in adsorption capacity was expected; while surface area analyses show no notable changes with hydration period or particle size. The pH dependent surface charge was three times higher using slow potentiometric titrations as compared to fast titrations (due largely to diffusion into pore space), with the surface acidity generally unaffected by hydration period. Results from batch adsorption experiments similarly show no change in fluoride adsorption capacity with hydration period. There was also no notable difference in fluoride adsorption capacity between the particle size ranges of 0.5–1.0 mm and 0.125–0.250 mm, or with hydration period. However, adsorption rate increased dramatically with the finer particle sizes: at an initial F− concentration of 0.53 mmol L−1 (10 mg L−1), 90% was adsorbed in the 0.125–0.250 mm range after 1 h, while the 0.5–1.0 mm range required 24 h to achieve 90% adsorption. Also, the pseudo-second-order adsorption rate constants for the finer vs. larger particle sizes were 3.7 and 0.5 g per mmol F− per min respectively (24 h); and the initial intraparticle diffusion rate of the former was 2.6 times faster than the latter. The results show that adsorption capacity of activated alumina remains consistent and high under the conditions evaluated in this study, but in order to increase adsorption rate, a relatively fine particle size is recommended.
The Next Microsoft? Skewness, Idiosyncratic Volatility, and Expected Returns

This paper analyzes the low subsequent returns of stocks with high idiosyncratic volatility, documented by prior research. There is substantial time-series co-variation between stocks with high idiosyncratic risk. I examine an alternative measure of aggregate skewness, the cross-sectional skewness of all firms at a given point in time. Cross-sectional skewness helps explain both the common time-variation and the premium associated with firms with high idiosyncratic volatility. Sensitivity to cross-sectional skewness is also related to the underperformance of Initial Public Offerings (IPOs) and small growth stocks. IPOs only underperform if they list in times of high cross-sectional skewness. These results imply that the low returns to IPOs, small growth stocks and highly volatile stocks are a result of a preference for skewness. Finally, proxies for technological change, such as lagged patent grant growth, predict future cross-sectional skewness. This suggests an economic interpretation of cross-sectional skewness as the result of changes in industry structure brought about by shocks such as significant technological change.
Regulation and Income Inequality: The Regressive Effects of Entry Regulations

We examine the relationship between entry regulations and income inequality. Entry regulations increase the cost of legally starting a business relative to the alternatives — working for someone else, entering illegally, or exiting the labor force. We hypothesize that such regulations may cause greater income inequality, because entrepreneurs at the bottom rungs of the income distribution may have relatively greater difficulty surmounting costly barriers to entry. Combining entry regulations data from the World Bank Doing Business Index with various measures of income inequality, including Gini coefficients and income shares, we examine a pooled cross-section of 175 countries and find that countries with more stringent entry regulations tend to experience higher levels of income inequality. An increase by one standard deviation in the number of procedures required to start a new business is associated with a 1.5 percent increase in the Gini coefficient and a 5.6 percent increase in the share of income going to the top 10 percent of earners. Although we cannot eliminate the possibility of reverse causality, we are unaware of any theory that posits that income inequality causes entry regulations. We therefore offer several simple recommendations designed to minimize regulations’ adverse effect on income inequality.
Damage mitigation techniques in wind turbine blades: A review:

Wind blades are major structural elements of wind turbines, but they are prone to damage like any other composite component. Blade damage can cause sudden structural failure and the associated cost...
Decreasing readmissions by focusing on complications and underlying reasons

Abstract Background To analyze demographics and outcomes of patients focusing on 30-day readmission status and identify procedure-specific risk factors. Methods Patients undergoing abdominal colorectal surgery (2011–2013) were identified Demographics and outcomes including in-hospital complications were compared based on readmission status. Results A total of 6637 patients were identified with a mean age of 51.2(±17.1) years. Seven hundred and seventy five(11.7%) patients were readmitted at least once within 30-day. The most common index procedures related to readmission were stoma closure (n = 127/775, 16.4%) and total colectomy (n = 105/775, 13.6%). Readmitted patients had longer length of index hospital stay (LOS)(8.2 ± 5.9 vs 7.9 ± 6.9 days,p Conclusion Increased postoperative complications may be the main preventable underlying reason for increased risk of hospital readmission after colorectal surgery. Preventive measures to decrease complications and actions to identify high risk patients for complications would help to reduce readmissions.
Cuboid and Nutcracker Fractures

This is a case presentation involving a complex foot injury noted to have first through third metatarsal fractures and a navicular fracture on plain radiographs and an associated cuboid and first metatarsal base fracture seen only on CT scan. A stepwise description of the approach to diagnosis, imaging, and surgery is outlined with a rationale to support the clinical treatment plan used in this case. Important emphasis is placed on edema control, adequate imaging with computed tomography and three-dimensional reformatting, and encouragement of clinical suspicion for associated foot injuries that are commonly missed. Utilizing a dual-incision approach the medial column was restored through direct visualization followed by the lateral column repair focusing on the cuboid. Patient outcome included a return to work and normal gait.
Pulmonary Diseases, a Matter of Time

Age-related progressive loss of lung function contributes to disability and premature death. How the circadian clock regulates the development and progression of age-related lung diseases, and the underlying molecular mechanisms, are still largely unknown. The chronobiology of the lung and the role of the circadian clock in the pathophysiology of age-related lung disease will be discussed in this chapter. We describe the molecular links between the circadian clock and the specific hallmarks of aging to provide a better understanding of healthy lung aging and age-related lung disease. Furthermore, the impact of external factors in the intrinsic circadian regulation will be integrated into the complex profiling of age-related lung diseases as well as chrono-therapeutic approaches. Finally, gaps in our knowledge and future directions will be discussed.
Dining in Utopia: A Taste of the Bulgarian Black Sea Coast under Socialism

This article explores the ways in which the Bulgarian socialist regime integrated a newly elaborated culture of food and drink into its promises for the “good life” and a utopian future. With a focus on Black Sea coast tourism, it argues that the development of more refined food and drink offerings and public dining venues played a dual role of shaping and serving a modern socialist citizenry. With tourism as a major engine of the Bulgarian economy, catering to Bulgarian, Bloc, and Western tourists meant that creating a gastronomic utopia by the sea was part and parcel of “building” and showcasing socialism. This was intimately tied to bolstering state legitimacy through the provision of leisure and abundance, but also to a newly minted Bulgarian national cuisine. By the late 1970s and 1980s, however, the Black Sea tourist phenomenon both exhibited and exacerbated the problem of growing shortages and hence the deep crisis of the system, which collapsed in 1989.
Independent Association Between Preoperative Cognitive Status and Discharge Location After Surgery: A Strategy to Reduce Resource Use After Surgery for Deformity

Background The aim of this study is to determine whether preoperative scores on a screening measure for cognitive status (the Saint Louis University mental status examination), were associated with discharge to a location other than home in older patients undergoing surgery for deformity. Methods Older patients (≥65 years) undergoing a planned elective spinal surgery for correction of adult degenerative scoliosis were enrolled in this study. Preoperative baseline cognition was assessed using the validated Saint Louis University mental status (SLUMS) test. SLUMS is 11 questions with a maximum of 30 points. Mild cognitive impairment was defined as a SLUMS score of 21–26 points, and severe cognitive impairment as a SLUMS score of 20 points or greater. Normal cognition was defined as a SLUMS score of 27 points or more. Postoperative length of stay and discharge location were recorded on all patients. Results Eighty-two subjects were included, with mean ± standard deviation age of 73.26 ± 6.08 years; 51% of patients were discharged to a facility (skilled nursing or acute rehabilitation). After adjustment for demographic variables, comorbidities, and baseline cognitive impairment, patients with preoperative cognitive impairment were 4-fold more likely to be discharged to a facility (skilled nursing or acute rehabilitation) compared with patients with normal cognitive status (odds ratio [OR], 3.93). In addition, patients who were not ambulatory before surgery were also more likely to be discharged to a facility (OR, 7.14). Conclusions In geriatric patients undergoing surgery for deformity correction, cognitive screening before surgery can identify patients with impaired cognitive status who are less likely than those with normal cognitive status to return home after surgery.
Esophagectomy for benign disease

Esophagectomy for benign disease is uncommonly used but it is an important option to consider in those patients who have lost function of this organ. Esophageal resection is, in fact considered as a last resort for benign disease, after multiple failed conservative treatments, when the primary disease is not amenable to other treatments and the esophagus has become non-functional leading to very poor quality of life. The indications for esophagectomy for benign diseases can be divided into three major categories: obstruction, perforation and dysmotility. The process leading to organ failure and the need for resection for each specific disease will be discussed in an attempt to provide guidance as to when an esophagectomy is appropriate.
Approach to assessing and using clinical practice guidelines

Clinical practice guidelines are produced in ever-increasing numbers by the American Academy of Neurology (AAN) and other developers, with over 1,000 guidelines currently in the National Guideline Clearinghouse. Knowing when to use guidelines in clinical practice requires neurologists to assess the rigor of published guidelines and understand how guideline recommendations are best applied in individual patient encounters. This review briefly describes guideline definitions and the AAN process for guideline development, outlines key elements for assessing guideline quality, and details a practical approach for incorporating guideline recommendations when partnering with patients in shared decision-making.
Application of In-Group Identification to Organizations: A Study of the Impact of Self-Investment and Self-Definition on Key Organizational Outcomes:

This study looks at the association of the two-dimensional measure of in-group identification on key organizational outcomes. In-group identification has been used in social psychology research on ...
Making "race" and nation in the United States, South Africa, and Brazil: Taking Making seriously

Recent scholarship on "race" has rejected the view that race is a natural, biological division among human beings, emphasizing instead its socially constructed, and hence historically variable, meanings.1 This insight has informed important research into particular cases of "racialization."2 It has also contributed to a renewed emphasis on the importance of studying "race" in comparative and historical perspective. However, despite calls for comparative analysis of the social construction of "race," there is still a paucity of serious comparative work among recent contributions to the field.
Skin endpoint titration. Still the standard

Skin endpoint titration, being both quantitative and calibrated in accordance with the patient's own reactivity, may still be considered the most sophisticated means of identifying an allergenic offender. Other forms of skin testing, simpler to perform, are rapidly becoming more uniform and quantitative. Laboratory tests provide more specific information and improved convenience. All occupy important positions in allergy diagnosis.
On Natural Geometry and Seeing Distance Directly in Descartes

As the word “optics” was understood from antiquity into and beyond the early modern period, it did not mean simply the physics and geometry of light, but meant the “theory of vision” and included what we should now call physiological and psychological aspects. From antiquity, these aspects were subject to geometrical analysis. Accordingly, the geometry of visual experience has long been an object of investigation.
Nonlinear acoustic wave propagation in tissue medium

Measurements to comply with labeling standards and FDA requirements for diagnostic equipment are performed in water, a medium readily available and easy to use. To predict the fields in tissue, an attenuating and absorbing medium, the FDA has established a derating factor of 0.3 dB/cm-MHz. This model, however, is based on a simple linear model which does not take into account the nonlinearity of the medium nor does it consider the effects of diffraction. The Khokhlov-Zabolotskaya-Kuznetsov (KZK) model for nonlinear thermoviscous diffractive waves is utilized. Using this model, the acoustic pressure amplitudes along the beam axis for the fundamental and the second and third harmonics are examined for a plane piston transducer of uniform excitation. Due to the presence of nonlinearities, the dissipation of energy due to attenuation, and acoustic saturation, the FDA derating underestimates the output pressure fields in tissue using simulations based on the KZK model
Privatization, Nationalization, and Aspects of Transition

This chapter treats some of the main themes found in the literature dealing with privatization, nationalization, and transition. It starts by surveying some of the main arguments that have been advanced in favor of nationalization. Subsequently, it reviews the growth of privatization. While it might seem axiomatic to some to treat the growth of privatization as a manifestation of the triumph of capitalism over socialism, there are some problematical considerations that would have to be addressed before any such treatment could be embraced.
The Differential Diagnosis in Nonlymphoproliferative Malignant Pleural Effusion Cytopathology and Its Correlation with Patients’ Demographics

Background: We report our experience with malignant pleural effusion (MPE) and the impact of patients’ demographics on the differential diagnosis at the primary site. Methods: After IRB approval, we searched our pathology database from January 2013 to January 2017 for patients with positive pleural effusions (PEs). Patients’ demographics and clinical histories were noted. Results: 474 patients were identified (288 females [61%] and 186 males [39%]), ranging in age from 19 to 64 years old. Ethnicity was distributed as follows: Caucasian (n = 330, 70%), African American (n = 114, 24%) and Asian (n = 30, 6%). The most common primary sites were the lung (n = 180, 37%), followed by the breast (n = 81, 17%), and the gynecologic system (67, 13%). The lung was the most common primary for all ethnicities (n = 190, 40%). The second-most common primary site was the breast in African Americans and Caucasians and upper gastrointestinal (GI) tract in Asians. In 5 cases (1%), the primary tumor could not be determined. Conclusion: Cytology examination is a useful method to diagnose primary sites of PE. Pulmonary primary is the most common cause of effusion in all ethnicities. In African American and Caucasian patients, the breast was the second-most common site of MPE, while in Asian patients it was the upper GI tract.
Psychiatric Manifestations of Autosomal Dominant Dopa Responsive Dystonia (P5.050)

Objective: To improve our understanding of psychiatric manifestations of anxiety and depression in autosomal dominant Dopa-Responsive Dystonia (DRD) attributed to GTP Cyclohydrolase mutations. Background: The gene producing autosomal dominant DRD, DYT-5, encodes the protein GTP-cyclohydrolase 1 (GCH-1) which is a necessary cofactor in the synthesis of biopterin. In addition to the conversion from tyrosine to l-dopa, biopterin is required for the hydroxylation reactions of tryptophan to serotonin. Thus, there also may be dysregulation of the serotonergic system. This deficiency may predispose to disorders such as anxiety and depression. To date, the data related to the presence of psychiatric disease in DRD/ GCH1 , while postulated, has been inconclusive. Design/Methods: A total of 54 patients were administered the psychiatric battery, the Composite International Diagnostic Interview (CIDI). Of these, 20 were manifesting carriers (17 women, 3 men) with a mean age of onset of 8 years old, 13 were non-manifesting carriers (8 women, 5 men) and 21 were non-carrying family members (11 women, 10 men). To discern if there was a gene effect, we compared all gene carriers to controls, and to detect if there was an effect present associated with dystonia we compared manifesting carriers to controls. Results: Our results showed 4:20 (20%) manifesting carriers, 3:13 (23%) non-manifesting, and 3:21 (14%) controls had major depression. 2:20 (10%) manifesting carriers and no non-manifesting carriers or controls had anxiety. Frequency of depression did not differ between carriers and non-carriers or between manifesting carriers and controls (p=0.72, p=0.69), nor did anxiety (p=0.52, p=0.23). Conclusions: Despite clinical and theoretical data suggesting that anxiety and depression would be greater in DRD, we did not demonstrate either a gene effect or an association with manifesting DRD in our sample, one of the largest of DRD participants. Further studies to increase sample size is ongoing. Disclosure: Dr. Neimand has nothing to disclose. Dr. Ortega has nothing to disclose. Dr. Raymond has nothing to disclose. Dr. Heiman has nothing to disclose. Dr. Bressman has nothing to disclose. Dr Saunders-Pullman has nothing to disclose.
ImWeb: cross-platform immersive web browsing for online 3D neuron database exploration

Web services have become one major way for people to obtain and explore information nowadays. However, web browsers currently only offer limited data analysis capabilities, especially for large-scale 3D datasets. This project presents a method of immersive web browsing (ImWeb) to enable effective exploration of multiple datasets over the web with augmented reality (AR) techniques. The ImWeb system allows inputs from both the web browser and AR and provides a set of immersive analytics methods for enhanced web browsing, exploration, comparison, and summary tasks. We have also integrated 3D neuron mining and abstraction approaches to support efficient analysis functions. The architecture of ImWeb system flexibly separates the tasks on web browser and AR and supports smooth networking among the system, so that ImWeb can be adopted by different platforms, such as desktops, large displays, and tablets. We use an online 3D neuron database to demonstrate that ImWeb enables new experiences of exploring 3D datasets over the web. We expect that our approach can be applied to various other online databases and become one useful addition to future web services.
Estimating Code Biases for Criticality Safety Applications with Few Relevant Benchmarks

Criticality safety analyses rely on the availability of relevant benchmark experiments to determine justifiable margins of subcriticality. When a target application lacks neutronically similar benc...
Evaluating the implementation and effectiveness of a multi-component intervention to reduce post-surgical opioid prescribing: study protocol of a mixed-methods design.

Introduction Opioids prescribed after surgery accounted for 5% of the 191 million opioid prescriptions filled in 2017. Approximately 80% of the opioid pills prescribed by surgical care providers remain unused, leaving a substantial number of opioids available for non-medical use. We developed a multi-component intervention to address surgical providers’ role in the overprescribing of opioids. Our study will determine effective strategies for reducing post-surgical prescribing while ensuring adequate post-surgery patient-reported pain-related outcomes, and will assess implementation of the strategies. Methods and analysis The Minimising Opioid Prescribing in Surgery study will implement a multi-component intervention, in an Illinois network of six hospitals (one academical, two large community and three small community hospitals), to decrease opioid analgesics prescribed after surgery. The multi-component intervention involves four domains: (1) patient expectation setting, (2) baseline assessment of opioid use, (3) perioperative pain control optimisation and (4) post-surgical opioid minimisation. Four surgical specialities (general, orthopaedics, urology and gynaecology) at the six hospitals will implement the intervention. A mixed-methods approach will be used to assess the implementation and effectiveness of the intervention. Data from the network’s enterprise data warehouse will be used to evaluate the intervention’s effect on post-surgical prescriptions and a survey will collect pain-related patient-reported outcomes. Intervention effectiveness will be determined using a triangulation design, mixed-methods approach with staggered speciality-specific implementation for contemporaneous control of opioid prescribing changes over time. The Consolidated Framework for Implementation Research will be used to evaluate the site-specific contextual factors and adaptations to achieve implementation at each site. Ethics and dissemination The study aims to identify the most effective hospital-type and speciality-specific intervention bundles for rapid dissemination into our 56-hospital learning collaborative and in hospitals throughout the USA. All study activities have been approved by the Northwestern University Institutional Review Board (ID STU00205053).
Review on Computational Modeling of Process–Microstructure–Property Relationships in Metal Additive Manufacturing

Metal additive manufacturing (AM) is an emerging technology with great potential for the fabrication of components with highly complex shapes at low cost. Its broad implementation, especially in safety-critical structural and high temperature applications, relies on the ability to produce AM parts with suitable and consistent mechanical properties. Current research indicates that computational modeling of the complex physical phenomena involved in AM can lead to shorter production times and less expensive material/component manufacturing, while simultaneously improving the residual stress distribution, distortion, microstructure, and porosity. These structural characteristics influence the mechanical properties of AM components, and the relationships between them must be identified to meet design specifications. This review organizes current research efforts described in literature and provides a systematic summary of available modeling techniques related to the simulation/prediction of process–microstructure–property relationships for AM-fabricated materials.
Safety of Checkpoint Inhibitors for Cancer Treatment in Patients with Multiple Sclerosis: A Case Report (P1.7-006)

Objective: To describe autoimmune outcomes in a patient with multiple sclerosis (MS) treated for lung cancer treated with programmed cell death ligand 1 (PD-L1) checkpoint inhibitor. Background: PD-L1 inhibitors have become an important treatment for non-small-cell lung cancer (NSCLC). Safety in patients with underlying autoimmune diseases has yet to be established. Design/Methods: This is a novel case report that describes the autoimmune outcomes for a patient with MS who was treated with atezolizumab. Results: A 46-year-old man with history of MS and stage IV metastatic NSCLC received a single dose of atezolizumab (PD-L1 checkpoint inhibitor). His MS had been diagnosed in 2001 after an optic neuritis, initially treated with interferon beta-1b then fingolimod for breakthrough disease. Fingolimod was stopped when he was diagnosed with cancer two years prior to presentation, at which point he had no evidence of active demyelination on brain MRI. Staging included positron emission tomography-computed tomography showing new left cerebellar lesion and concern for other brain metastasis. Cerebrospinal fluid (CSF) analysis showed 6 cells/uL with 71% lymphocytes, protein of 51, normal IgG index, positive oligoclonal bands isolated to CSF. He had whole brain radiotherapy (RT) with 3000 cGy over 10 fractions, followed by cisplatin/etoposide for 3 cycles. Five months after RT, he received one dose of atezolizumab. His tumoral load had dramatically stabilized after this treatment, but subsequent MRI monitoring revealed new enhancing brain lesions concerning for demyelination in conjunction with months of neurological deterioration. Brain biopsy was consistent with demyelination. Worsening MS was treated with rituximab, but failed to achieve remission. Subsequent MRIs revealed refractory new demyelinating lesions and rapid brain atrophy. Conclusions: PD-1 and PD-L1 checkpoint inhibitors have become an important treatment for NSCLC. To our knowledge this is the first case report of atezolizumab associated central nervous system autoimmune complications, specifically treatment-refractory demyelinating disease. Disclosure: Dr. Isitan has nothing to disclose. Dr. Wesley has received personal compensation in an editorial capacity for Elsevier and Clinical Therapeutics.
The End of First-Epoch Socialism and the Problem of Transition

This essay, written in 1989–90 as the Soviet Union was collapsing, challenges the triumphalism of capitalism’s defenders. It characterizes the 1917–89 period not as “the” epoch of socialism but only as its “first epoch.” The form of socialism that evolved in the Soviet Union, under conditions of widespread poverty and under pressure of external attacks and threats, was one that failed to develop democratic structures. While this much is widely recognized, what is often forgotten is how the global presence of the Soviet “pole,” despite its negative aspects, facilitated progressive developments elsewhere. The dialectics of transformation are discussed, and the position of an isolated anti-capitalist regime is compared to that of a dissident and besieged working class.
Mixing in ICF implosions on the National Ignition Facility caused by the fill-tube

The micrometer-scale tube that fills capsules with thermonuclear fuel in inertial confinement fusion experiments at the National Ignition Facility is also one of the implosion's main degradation sources. It seeds a perturbation that injects the ablator material into the center, radiating away some of the hot-spot energy. This paper discusses how the perturbation arises in experiments using high-density carbon ablators and how the ablator mix interacts once it enters the hot-spot. Both modeling and experiments show an in-flight areal-density perturbation and localized x-ray emission at stagnation from the fill-tube. Simulations suggest that the fill-tube is degrading an otherwise 1D implosion by ∼2×, but when other degradation sources are present, the yield reduction is closer to 20%. Characteristics of the fill-tube assembly, such as the through-hole size and the glue mass, alter the dynamics and magnitude of the degradation. These aspects point the way toward improvements in the design, some of which (smaller diameter fill-tube) have already shown improvements.
The greening of the Northern Great Plains and its biogeochemical precursors.

Vegetation greenness has increased across much of the global land surface over recent decades. This trend is projected to continue-particularly in northern latitudes-but future greening may be constrained by nutrient availability needed for plant carbon (C) assimilation in response to CO2 enrichment (eCO2 ). eCO2 impacts foliar chemistry and function, yet the relative strengths of these effects versus climate in driving patterns of vegetative greening remain uncertain. Here we combine satellite measurements of greening with a 135 year record of plant C and nitrogen (N) concentrations and stable isotope ratios (δ13 C and δ15 N) in the Northern Great Plains (NGP) of North America to examine N constraints on greening. We document significant greening over the past two decades with the highest proportional increases in net greening occurring in the dries and warmest areas. In contrast to the climate dependency of greening, we find spatially uniform increases in leaf-level intercellular CO2 and intrinsic water use efficiency that track rising atmospheric CO2 . Despite large spatial variation in greening, we find sustained and climate-independent declines in foliar N over the last century. Parallel declines in foliar δ15 N and increases in C:N ratios point to diminished N availability as the likely cause. The simultaneous increase in greening and decline in foliar N across our study area points to increased N use efficiency (NUE) over the last two decades. However, our results suggest that plant NUE responses are likely insufficient to sustain observed greening trends in NGP grasslands in the future.
The coupling of global brain activity and cerebrospinal fluid inflow is correlated with Alzheimer’s disease related pathology

The glymphatic system plays an important role in clearing the amyloid-β and tau proteins that are closely linked to Alzheimer9s disease (AD) pathology. Glymphatic clearance, as well as amyloid-β accumulation, is highly dependent on sleep, but the sleep-dependent driving forces behind cerebrospinal fluid (CSF) movements essential to the glymphatic flux remain largely unclear. Recent studies have reported that widespread, high-amplitude spontaneous brain activations in the drowsy state and during sleep, which are shown as large global signal peaks in resting-state fMRI, is coupled with the CSF movements, suggesting their potential link to the glymphatic flux and metabolite clearance. By analyzing multimodal data from the Alzheimer9s Disease Neuroimaging Initiative project, here we showed that the coupling between the global fMRI signal and CSF influx is correlated with AD-related pathology, including various risk factors for AD, the severity of AD-related diseases, the cortical amyloid-β level, and the cognitive decline over a two-year follow-up. These results provide critical initial evidence for involvement of sleep-dependent global brain activity, as well as the associated physiological modulations, in the clearance of AD-related brain waste.
HIPAA Privacy and Security: Issues for Employer-Sponsored Health Plans

This article discusses issues about privacy standards and provides an overview of security issues related to the Health Insurance Portability and Accountability Act ("HIPAA"). Some of the privacy issues include who must comply, what information is protected, and permissible disclosure of protected information. The overview of security issues covers administrative, physical, and technical safeguards, as well as organizational requirements. Any practitioner who works with employers that sponsor a health plan for their employees should be aware of these issues, as this is a new area of potential risk for those clients.
Problematic Smartphone Use Influences the Relationship Between Experiential Avoidance and Anxiety

Experiential avoidance (EA), an unwillingness to stay in contact with unwanted inner experiences (e.g., emotions, thoughts, and bodily sensations), has been implicated in the development and mainte...
Assessment of automatic cephalometric landmark identification using artificial intelligence.

Hypothesis and Objective: To compare the accuracy of cephalometric landmark identification between Artificial Intelligence (AI) Deep Learning Convolutional Neural Networks YOLOv3 algorithm and Manually Traced (MT) group. Methods: AAOF Legacy Denver collection was used to obtain 110 cephalometric images for this study. Lateral cephalograms were digitized by orthodontic resident in Dolphin Imaging after intra- and inter reliability check. The same images were uploaded to AI software Ceppro DDH Inc. Cartesian system of coordinates with Sela as 0:0 was used to extract x and y coordinate for 16 cephalometric points: Nasion, A point, B point, Menton, Gonion, Upper incisor tip, Lower incisor tip, Upper incisor apex, Lower incisor apex, Anterior Nasal Spine, Posterior Nasal Spine, Pogonion, Pterigomaxillary fissure point, Basion, Articulare and Orbitale. The mean distances were assessed relative to the reference value of 2 mms. Student paired t-tests at significance level of 5 % were used to compare the mean differences in each of the X- and Y-components. SPSS (IBM-vs. 27.0) software was use for the data analysis. Results: The results showed that there is no statistical difference for 12 out of 16 points when analyzing absolute difference between MT and AI group. Success detection rate for AI within 2 mm while comparing MT and AI group was 75 % and 93% within 4 mm. Conclusions: AI could be considered a promising tool to facilitate cephalometric tracing process in routine clinical practice and in research settings. Funding: no funding. IRB and/or ACC Protocol #: 2019-1180. Notice of Determination: activity Does Not Represent Human Subjects Research.
Doing Research to Improve Teaching and Learning: A Guide for College and University Faculty

Preface Chapter 1: What Are "Teaching as Research" and the "Scholarship of Teaching and Learning" and Why Should Everyone in Higher Education Care? Chapter 2: Doing Classroom Research In Higher Education-The Possibilities And Limitations Chapter 3: Qualitative Research Methods In Teaching And Learning Chapter 4: Quantitative Research Methods In Teaching and Learning Chapter 5: Using Assessment Data As Research Evidence To Improve Teaching And Learning Chapter 6: Mixed Methods And Triangulation Of Evidence Chapter 7: Case Studies And Pilot Studies Chapter 8: Reflective Collaborative Research Working Groups To Close The Loop And Continue The Process Chapter 9: Conclusions, So What And Now What Appendix References Contributors
Chapter 9 Role of Intracellular pH in Lymphocyte Activation

Publisher Summary Biochemical events associated with lymphocyte activation are initiated on the binding of ligand or lectin to the cell surface, leading to a cascade of signals transmitted from the membrane to the cell interior. Activation of certain pathways results in entry into the cell cycle while others prepare the cell for increased metabolic activity or maintain homeostasis. Lymphocyte activation has been shown to cause intracellular pH (pH i ), to either increase or decrease. The time course for altering pH i , is generally rapid, within 1-10 min, especially in T lymphocytes but may take 30-60 min in B lymphocytes stimulated with cytokines. Increased pH i most often results from the increased activity of the Na + /H + antiport. Increasing the activity of the antiport is not dependent on changes in [Ca 2+ ] i nor is it dependent on protein kinase C activity, though protein kinase C can activate the Na + /H + antiport in some settings. Decreased pH i occurs in mitogen- or antibody-stimulated human T lymphocytes. Decreased pH i requires an influx of extracellular Ca 2+ . The changes in pH i that accompany lymphocyte activation may serve to modulate lymphocyte response to ligand or may be important for maintaining intracellular homeostasis in the face of increased metabolism.