cssi/SciSciGPT-SciSciNet huggingface dataset:
The effect of early weaning on feedlot performance and measures of stress in beef calves

Forty crossbred steers (Brahman x English) were categorized into two groups: 1) early weaned (EW; n = 20); and 2) normal weaned (NW; n = 20). Calves were 89 and 300 d of age at the time of EW and NW, respectively; SEM = 4.4. Early-weaned calves were kept on-site (University of Florida, Ona), provided supplement (1% of BW), and grazed on annual and perennial pastures until NW. At the time of normal weaning, all calves were loaded on a commercial livestock trailer and transported to the North Carolina State University Research Feedlot in Butner (approximately 1,200 km). Upon arrival, calves were stratified by BW and randomly allotted to four pens per weaning age treatment. Individual calf BW and blood samples were collected at the time of normal weaning, on arrival at the feedlot (d 1; 24 h following weaning), and on d 3, 7, 14, 21, and 28 of the receiving period. Individual BW was collected at the start and end of the growing and finishing periods, and feed intake by pen was measured daily. As an estimate of stress during the receiving period, plasma was collected and analyzed for the acute-phase proteins, haptoglobin and ceruloplasmin. Early-weaned calves were lighter (P = 0.03) at normal weaning than NW calves (221 vs. 269 kg; SEM = 10.6). By d 28, EW calves tended (P = 0.12) to be lighter than NW calves (242 vs. 282 kg, respectively). Gain:feed was improved for EW compared with NW calves during both the receiving (G:F = 0.157 vs. 0.081) and growing (0.159 vs. 0.136) periods. There tended (P < 0.10) to be weaning age x day interactions for each acute-phase protein. Ceruloplasmin concentrations increased in NW, but not EW calves, and peaked on d 7 (27.6 and 34.2 mg/100 mL for EW and NW calves, respectively; P < 0.05). Haptoglobin concentrations increased in both groups and were greatest (P < 0.05) in NW calves on d 3 (7.63 vs. 14.86 mg of haptoglobin/hemoglobin complexing/100 mL). No differences in ADG or G:F were detected during the finishing phase; however, overall G:F was improved (P = 0.03) for EW vs. NW calves (0.155 vs. 0.136). Carcass measures, including backfat thickness, USDA yield grade, marbling score, and LM area, did not differ between treatments. These data imply that EW calves, which are maintained onsite before shipping, may be more tolerant to the stressors associated with transportation and feed yard entry. Early weaned calves, managed within the system described in this study, may have improved G:F.
Teaching Project Management Skills: An Example of Collaboration between a University and the Local PMI Chapter

The demand for project management skills in industry is increasing; however the number of individuals who can meet the demand is decreasing. Universities are addressing these changes by developing project management degree programs. In this paper we describe the experience of a collaborative effort between one University and a local chapter of the Project Management Institute (PMI). The result is a popular and highly successful program in which project management professionals from the PMI are engaged in student learning by providing a guest lecture series, serving as mentors for class projects, providing actual organizational projects for students to analyze and apply class concepts, and serving as judges on student team project competitions. The results are students who receive a rigorous education, hands on experience in industry, form relationships with, and learn practical skills from PMI volunteers; grounding their formal education in practical industry experience.
Soil Structure and Aggregation

The arrangement or organization of the particles in the soil—that is, the internal configuration of the soil matrix—is called soil structure. Because soil particles differ in shape, size, and orientation and can be variously associated and interlinked, their mass can form complex and irregular patterns that are difficult to characterize in exact geometric terms. Soil structure is affected by changes in climate, biological activity, and soil management practices, and it is vulnerable to the destructive forces of a mechanical and physicochemical nature. For these various reasons, there is no truly objective or universally applicable way to measure soil structure per se, and the term soil structure therefore expresses a qualitative concept rather than a directly quantifiable property. The numerous methods proposed for characterizing soil structure are designed not to measure soil structure itself but soil attributes that are supposed to depend on structure. Many of these methods are specific to the purpose for which they are devised, and some are completely arbitrary.
Accessing Marine Microbial Diversity for Drug Discovery

Abstract Marine bacteria are beginning to occupy a central role in the discovery of new bioactive molecules. The diversity of marine microbial habitats, each with its unique environmental traits and characteristic dominance of certain bacterial Phyla, are described herein. Sampling strategies for deep-sea marine sediments, as well as isolation methods are described. Bacterial culturing methods are presented based on our own experience working with marine bacteria. We provide a short review of significant metabolites isolated, and present three case studies of salinosporamide A, currently in clinical trials for the treatment of cancer, as well as the abyssomicins and thiocoralines, which show significant promise for clinical development. Given the brief format of this chapter, it is simply not feasible to do a comprehensive review. Rather, interesting highlights of the status of marine microbial drug discovery, many examples from our own work, have been selected to demonstrate the growing sophistication of this field of inquiry. Apologies are thus due to the many authors whose important and insightful contributions were not cited.
Outcomes After Cryoablation Versus Partial Nephrectomy for Sporadic Renal Tumors in a Solitary Kidney: A Propensity Score Analysis.

Abstract Background While partial nephrectomy (PN) is considered the standard approach for a tumor in a solitary kidney, percutaneous cryoablation (PCA) is emerging as an alternative nephron-sparing option. Objective To compare outcomes between PCA and PN for tumors in a solitary kidney. Design, setting, and participants Patients who underwent PCA or PN between 2005 and 2015 for a single primary renal tumor in a solitary kidney were identified using Mayo Clinic Registries. Exclusion criteria were inherited tumor syndromes and salvage procedures. Intervention PCA and PN. Outcome measurements and statistical analysis To achieve balance in baseline characteristics, we used inverse probability of treatment weighting (IPTW) based on propensity to receive treatment. The risk of having a post-treatment complication and percent drop in estimated glomerular filtration rate (eGFR), as well as the risks of local/ipsilateral recurrence, distant metastasis, and cancer-specific mortality, were compared between groups using logistic, linear, and Fine-and-Gray competing risk regression models. Results and limitations The cohort included 118 patients (PCA: 54; PN: 64) with a median follow-up of 47 mo (interquartile range 18, 74). In unadjusted analyses, PCA was associated with a lower risk of complications (15% vs 31%; odds ratio [OR]=0.38; 95% confidence interval [CI] 0.15, 0.96; p =0.04). However, upon accounting for baseline differences with IPTW adjustment, there was no longer a significant difference in the risk of complications (28% vs 29%; OR=0.95; 95% CI 0.53, 1.69; p =0.9). There were no significant differences between PCA and PN in percentage drop in eGFR at discharge (mean: 11% vs 16%; β =–5%; 95% CI –13, 3; p =0.2) or at 3 mo (12% vs 9%; β =3%; 95% CI –3, 10; p =0.3). Likewise, no significant differences were noted in local recurrence (HR=0.87; 95% CI 0.38, 1.98; p =0.7), distant metastases (HR=0.60; 95% CI 0.30, 1.20; p =0.2), or cancer-specific mortality (HR=1.13; 95% CI 0.32, 3.98; p =0.8). Limitations include the sample size, given the relative rarity of renal masses in solitary kidneys. Conclusions Our study found no significant difference in complications, renal function outcomes, and oncologic outcomes between PN and PCA for patients with a tumor in a solitary kidney. Validation in a larger multi-institutional analysis may be warranted. Patient summary Partial nephrectomy (surgery) and percutaneous cryoablation are both options for treating a kidney tumor while preserving the normal portion of the kidney. In patients with a tumor in their only kidney, we found no difference in the risk of complications, kidney function outcomes, or cancer control outcomes between these two approaches.
Ultrasound-Guided Bar Edge Labeling in the Perioperative Assessment of Nuss Bar Removal.

Abstract Introduction: Nuss bar removal after minimally invasive repair of pectus excavatum in patients where bar ends are not palpable, can be a challenging procedure for the surgeon; a blind diss...
The Social Transmission of Associative Fear in Rodents—Individual Differences in Fear Conditioning by Proxy

Abstract Pairing a neutral cue (e.g., a tone) with an inherently aversive unconditioned stimulus (US; e.g., a footshock) creates an associative memory such that later presentations of the now conditioned stimulus alone elicit a conditioned fear response (e.g., freezing). This direct associative learning is only one technique through which individuals can learn about potential threats. However, the convenient design and robust responses makes direct fear conditioning the most frequently used paradigm in the research of fear and anxiety disorders. Fear can also be acquired from a social context, such as observing the fear expression of a conspecific or witnessing another animal during a dangerous encounter. The extent to which nonprimate laboratory animals engage in learning strategies based on vicarious experience is remarkably scantily characterized. Recently, attempts to determine the conditions that allow the social transmission of fear in laboratory rodents have gained traction, with results and interpretations varying to a great degree. Utilizing a modified demonstrator–observer paradigm that allows free interaction between subjects—fear conditioning by proxy—we explore the ability of rats to learn an associative fear response vicariously. Here, we review how certain individual traits in the current situational state of the subjects may either facilitate or impede learning in this social fear-conditioning paradigm and discuss how fear conditioning by proxy learning relates to empathy seen in humans.
Impact of radiotracer injection latency and seizure duration on subtraction ictal SPECT co-registered to MRI (SISCOM) performance in children.

Abstract Objective We evaluated the impact of radiotracer injection latency and post-injection seizure duration on subtraction ictal SPECT co-registered to MRI (SISCOM) test performance in identifying the epileptogenic zone (EZ) in children with drug-resistant epilepsy who had undergone a resective epilepsy surgery. Methods SISCOM concordance with the EZ was retrospectively reviewed to evaluate its performance in 113 children. The impact of radiotracer injection latency and post-injection seizure duration was evaluated for their predictive value of SISCOM localization accuracy. Results The overall sensitivity and specificity of SISCOM in identifying an EZ was 64.8% (95%CI = 50.6–77.3) and 40.7% (95%CI = 28.1–54.3). The positive likelihood ratio and diagnostic odd ratio was 1.09 (95%CI = 0.80–1.48) and 1.26 (95%CI = 0.59–2.71), respectively. Logistic regression showed that injection latency and post-injection seizure duration did not significantly predict the probability of true positive SISCOM (p-value = 0.45 and 0.29, respectively). Conclusion Radiotracer injection latency and post-injection seizure duration were not shown to have a statistical significant impact on SISCOM performance in identifying the EZ. Significance This study demonstrates that further study of factors contributing to the performance of SISCOM in EZ identification in children is needed.
Vulvovaginitis. When Candida becomes a problem.

Vulvovaginitis caused by the Candida species is extremely common, widespread, and affects all strata of society. The overwhelming majority of infections are uncomplicated and respond well to conventional antifungal therapy, regardless of route of administration or duration of therapy. Complicated Candida infections, although representing a minority of episodes, still constitute an enormous challenge to our therapeutic skills (Table 1). As indicated in Display Box 1, genital infection by Candida becomes a problem under a variety of circumstances including host and microorganism factors.
Relapse Prevention: Clinical Strategies for Substance Use Disorders

Publisher Summary This chapter summarizes the major tenets of relapse prevention (RP) including the concepts of lapse, relapse, and recovery, and the hypothesized common relapse precipitants and determinants. Relapse is defined as a process that slowly and gradually leads to the initiation of substance use or engagement in the behavior after a period of abstinence. It has been shown that a lapse does not necessarily herald a full-blown relapse in users of opiates. Several studies and reviews have shown that RP does help improve recovery and reduce relapse rates and that RP is more effective than no-treatment control groups and is equally effective as other active treatment, such as supportive therapy and interpersonal psychotherapy, in improving substance use outcomes, including reduction in severity of relapses when they occur and durability of effects. Individuals with higher levels of impairment along dimensions, such as psychiatric severity, appear to benefit most from RP compared with those with less severe levels of impairment. The details of relapse replication and extension project are also presented.
A versatile taxonomy of low-dimensional vortex models for unsteady aerodynamics

Inviscid vortex models have been demonstrated to capture the essential physics of massively separated flows past aerodynamic surfaces, but they become computationally expensive as coherent vortex structures are formed and the wake is developed. In this work, we present a two-dimensional vortex model in which vortex sheets represent shear layers that separate from sharp edges of the body and point vortices represent the rolled-up cores of these shear layers and the other coherent vortices in the wake. We develop a circulation transfer procedure that enables each vortex sheet to feed its circulation into a point vortex instead of rolling up. This procedure reduces the number of computational elements required to capture the dynamics of vortex formation while eliminating the spurious force that manifests when transferring circulation between vortex elements. By tuning the rate at which the vortex sheets are siphoned into the point vortices, we can adjust the balance between the model’s dimensionality and dynamical richness, enabling it to span the entire taxonomy of inviscid vortex models. This hybrid model can capture the development and subsequent shedding of the starting vortices with insignificant wall-clock time and remain sufficiently low-dimensional to simulate long-time-horizon events such as periodic bluff-body shedding. We demonstrate the viability of the method by modelling the impulsive translation of a wing at various fixed angles of attack, pitch-up manoeuvres that linearly increase the angle of attack from , and oscillatory pitching and heaving. We show that the proposed model correctly predicts the dynamics of large-scale vortical structures in the flow by comparing the distributions of vorticity and force responses from results of the proposed model with a model using only vortex sheets and, in some cases, high-fidelity viscous simulation.
Defining the "Problem Resident" and the Implications of the Unfixable Problem: The Rationale for a "Front-door" Solution.

Author(s): Taira, Taku; Santen, Sally A.; Roberts, Nicole K. | Abstract: Introduction: Problem residents are common in graduate medical education, yet little is known about their characteristics, deficits, and the consequences for emergency medicine (EM) residencies. The American Board of Internal Medicine (ABIM) defines a problem resident as “a trainee who demonstrates a significant enough problem that requires intervention by someone of authority, usually the program director [PD] or chief resident.” Although this is a comprehensive definition, it lacks specificity. Our study seeks to add granularity and nuance to the definition of “problem resident,” which can be used to guide the recruitment, selection, and training of residents. Methods: We conducted semi-structured interviews with a convenience sample of EM PDs between 2011 and 2012. We performed qualitative analysis of the resulting transcripts with our thematic analysis based on the principles of grounded theory. We reached thematic sufficiency after 17 interviews. Interviews were coded as a team through consensus. Results: The analysis identified diversity in the type, severity, fixability, and attribution of problems among problem residents. PDs applied a variety of thresholds to define a problem resident with many directly rejecting the ABIM definition. There was consistency in defining academic problems and some medical problems as “fixable.” In contrast, personality problems were consistently defined as “non-fixable.” Despite the diversity of the definition, there was consensus that residents who caused “turbulence” were problem residents. Conclusion: The ABIM definition of the problem resident captures trainees who many PDs do not consider problem residents. We propose that an alternative definition of the problem resident would be “a resident with a negative sphere of influence beyond their personal struggle.” This combination acknowledges the identified themes of turbulence and the diversity of threshold. Further, the combination of PDs’ unwillingness to terminate trainees and the presence of non-fixable problems implies the need for a “front-door” solution that emphasizes personality issues at the potential expense of academic potential. This “front-door” solution depends on the commitment of all stakeholders including medical schools, the Association of American Medical Colleges, and PDs.
Effect of Teriflunomide and Dimethyl Fumarate on Cortical Atrophy and Leptomeningeal Inflammation in Multiple Sclerosis: A Retrospective, Observational, Case-Control Pilot Study.

Background: Pathologic changes in cortical gray matter (GM) and leptomeninges contribute to disability worsening in patients with multiple sclerosis (MS), but there is little evidence whether disease-modifying treatments can slow down cortical pathology in MS. Objectives: To investigate the effect of teriflunomide (TFM) and dimethyl fumarate (DMF) in reducing cortical pathology, as determined by percentage cortical volume change (PCVC) and leptomeningeal contrast enhancement (LMCE) on MRI. Methods: This was a retrospective, single-center, observational study that selected 60 TFM- and 60 DMF-treated MS patients over 24 months. Results: TFM had a lower rate of PCVC compared to DMF over 24 months (−0.2% vs. −2.94%, p = 0.004). Similar results were observed for percentage GM volume change over 0–12 (p = 0.044) and 0–24 (−0.44% vs. −3.12%, p = 0.015) months. No significant differences were found between the TFM and DMF groups in the frequency and number of LMCE foci over the follow-up. TFM showed a numerically lower rate of whole brain atrophy over 24 months (p = 0.077), compared to DMF. No significant clinical or MRI lesion differences between TFM and DMF were detected over follow-up. Conclusions: These findings suggest that TFM has a superior effect on the preservation of cortical GM volume, compared to DMF.
Industrial APP Design for Data Dynamic Monitoring of Strip Production Process

Strip is a kind of material which is widely used in many industries. At present, the market demand for high precision and high quality strip is huge. As the bottom equipment of the production process, the running state of the strip production equipment is of great significance to the quality of the strip. In this paper, aiming at the regional limitation of current equipment monitoring system, we design and implement a mobile APP for real-time monitoring the running state of field equipment by using mobile interconnection technology. Using mobile APP can reduce monitoring costs and achieve real time monitoring of device parameters effectively. In this paper, OPC communication protocol, Socket communication and mobile interconnection technology are used to provide a new idea for intelligent monitoring.
Occupational Therapy in Mental Health: A Vision for Participation

Brown, Stoffel, and Munoz’s Occupational Therapy in Mental Health: A Vision for Participation (2nd ed.) is once again the most comprehensive occupational therapy text available in the area of menta...
Sustainability planning by Metropolitan Planning Organizations: California and national trends

Abstract Regional transportation plans in the United States have been shaped not only by transportation policy but also by environmental and civil rights legislation, funding constraints, a shift in orientation from construction to systems management, and in many urban areas, growing housing problems and market and stakeholder interest in transit-oriented development. In response to this complex policy landscape, many Metropolitan Planning Organizations (MPOs) – federally-mandated regional transportation planning agencies – have taken on a broader scope of activities, engaging, to varying degrees, in sustainability planning, defined here as planning that links regional transportation investments with land use and environmental strategies, guided by concerns about the regional economy, social equity, and natural environment (the “three E’s”). From the literature, seven attributes of sustainable regional transportation planning are identified and operationalized into measures applied to a review of planning documents for the largest 48 MPOs in the United States. The review indicates that while most MPOs exhibited some attributes of sustainability planning as of 2016, none exhibited all of them. A deeper investigation is presented of California cases, where a state law adopted in 2008 mandates coordinated transportation and land use planning at the regional scale in order to reduce greenhouse gas (GHG) emissions. The investigation indicates that California’s largest MPOs have advanced sustainable land use and transport somewhat more aggressively since the law’s passage, especially regarding travel mode share and compact housing. Innovative planning strategies have included asking local governments to designate priority development areas for compact development, and providing financial incentives for local actions to support the regional plans. The analysis concludes that California’s policy framework for systematizing regional sustainability planning has provided a venue for robust dialogue on inter-governmental roles and responsibilities, but it has not yet led to but it has not yet led to the adoption of implementation programs and policy measures sufficient to ensure the law’s success.
Are we there yet? The long walk towards the development of efficient symbiotic associations between nitrogen-fixing bacteria and non-leguminous crops

Nitrogen is an essential element of life, and nitrogen availability often limits crop yields. Since the Green Revolution, massive amounts of synthetic nitrogen fertilizers have been produced from atmospheric nitrogen and natural gas, threatening the sustainability of global food production and degrading the environment. There is a need for alternative means of bringing nitrogen to crops, and taking greater advantage of biological nitrogen fixation seems a logical option. Legumes are used in most cropping systems around the world because of the nitrogen-fixing symbiosis with rhizobia. However, the world's three major cereal crops—rice, wheat, and maize—do not associate with rhizobia. In this review, we will survey how genetic approaches in rhizobia and their legume hosts allowed tremendous progress in understanding the molecular mechanisms controlling root nodule symbioses, and how this knowledge paves the way for engineering such associations in non-legume crops. We will also discuss challenges in bringing these systems into the field and how they can be surmounted by interdisciplinary collaborations between synthetic biologists, microbiologists, plant biologists, breeders, agronomists, and policymakers.
P30 Perceptions of Online Grocery Shopping Using the Supplemental Nutrition Assistance Program Electronic Benefit Transfer Card

Background There is formative legislation proposing to expand use of the Supplemental Nutrition Assistance Program (SNAP) Electronic Benefit Transfer (EBT) card to allow for online grocery store purchases. However, there are limited studies reporting SNAP recipients’ perceptions of online EBT shopping, particularly among those in highest need of such a program (ie, limited-income caregivers of young children who face multiple external barriers (eg, time and money) to supporting healthy eating and meal patterns for their families). Without this information, it will not be possible to develop and implement a fully optimized online EBT policy and program. Objective The main objective of this qualitative study is to explore the general and contextual (ie, within family mealtime routines) perceptions of an online EBT program among caregivers with children enrolled in Head Start. Study Design, Setting, Participants This focus group study is ongoing. Two were completed in fall 2019 and additional focus groups will be conducted in winter 2020 until saturation is met. Participants (n = 16) are primarily non-Hispanic Black (88%) and 100% female. Mean (SD) is 40.7 ± 15.5 years and median income is $42,302. Measurable Outcome/Analysis Main outcomes are general and contextual perceptions of online EBT shopping. Focus groups were recorded and transcribed verbatim. Data were independently coded by 2 researchers and analyzed for themes. Results On average, focus groups lasted 75 minutes. A preliminary theme includes mixed awareness of grocery delivery/curbside pickup but with an overall positive perception. Two participants regularly participate in online delivery and find it very convenient. The majority of participants did not feel that online grocery shopping would improve healthy eating and most had reservations about others picking out fresh produce and meats. When asked about using SNAP benefit/EBT card to purchase food online, participants who receive it believe it would encourage them to use this program. Conclusions Results of this study will form the design of a future online EBT pilot study tailored to the needs of Head Start families.
Role of Thyroid Hormone and Oxidant Stress in Cardiovascular Diseases.

BACKGROUND Cardiovascular-diseases (CVD) are caused by different metabolic-anomalies related to hypertension/sedentary lifestyle/drug-addiction/dyslipidemia and diabetes. The scanty report suggests that metabolic-rate regulating thyroid hormones are linked to CVD. METHODS A total of 59 individuals (male, >45 yrs) were involved in this study. Blood-samples from diagnosed cardiac-patients troponin (N=13, trop-T+), individuals with high-risk (N=15) (high glucose/cholesterol/triglycerides), and with age-matched controls (N=31) were tested for the evaluation of lipid-profiles/thyroid-hormones; Triiodothyronine, Thyroxine, and thyroid-stimulating hormone (T3/T4/TSH), blood-glucose/oxidative-stress indicators like malondialdehyde(MDA)/ non-protein-soluble-thiol(NPSH) and metabolic inflammatory-marker; human C-reactive protein hsCRP by biochemical-methods/ELISA. RESULTS Correlation-data suggest that in normal conditions, there is no significant correlation between thyroid-hormones and other parameters. On the contrary, blood-glucose/triglyceride/uric-acid/ proteins are correlated in cardiac and high-risk patients, suggesting hypermetabolic conversion of nutrients by biochemical connectors like the TCA cycle and gluconeogenesis pathways. Further, the hypermetabolic-state is favored by the rise in the thyroid hormones level. In the high-glucose group, there is a significant correlation between metabolic-parameter and oxidative-stress indices like uric-acid/NPSH/MDA. T3 and T4 have also been linked to the serum-protein. But in the trop t+ group, all thyroid hormones have been significantly associated with blood cholesterol/triglyceride and glucose, suggesting the increasing involvement of thyroid-hormone in risk-factors and disease groups. The hsCRP level was ~100% and ~5-fold higher in high cholesterol and trop t+ groups, respectively. T3 was also ~70%, ~4.5-fold, and ~3.5-fold higher in high-glucose/high-cholesterol/ trop-t+ groups, respectively. This suggests that T3/TSH is linked to pathogenesis and severity. CONCLUSION Dyslipidemia, oxidant-stress in association with T3, augments cardiac-pathogenesis.
Evaluation of a Care Management Program for Pediatric Epilepsy Patients.

Objective:To evaluate the impact of a pediatric epilepsy care management intervention on emergency department visits, hospitalizations, and seizure freedom.Methods:We conducted a prospective observ...
Obstetrician patterns of steroid administration for the prenatal management of congenital pulmonary airway malformations.

BACKGROUND Congenital pulmonary airway malformation (CPAM) is the most common prenatally-diagnosed lung malformation. This lesion, classified as macrocystic or microcystic, can lead to significant fetal compromise. Management options include observation, maternal antenatal steroid administration, and fetal surgical intervention. Current evidence suggests that microcystic (but not macrocystic) lesions and those with a cyst volume ratio (CVR) >1.6 are responsive to steroid therapy. The objective of this study was to identify patterns of prenatal steroid administration for the management of CPAMs and to identify characteristics of CPAMs prompting steroid administration. METHODS An 18-question survey was distributed to obstetricians from the Pregnancy-Related Care Research Network (PRCRN) and the North American Fetal Therapy Network (NAFTNet), from January to April 2019, to capture antenatal steroid prescribing patterns. RESULTS Response rates were 28.3% (138/487) for PRCRN and 63.3% (19/30) for NAFTNet. Among PRCRN members, 16.8% administered prenatal steroids, with most (77.2%) doing so for both microcystic and macrocystic CPAMs; corresponding percentages for NAFTNet members were 90.9% and 52.6%. Two thirds (65.6%) of obstetricians who administer steroids do so for a CVR > 1.6, without evidence of mediastinal shift or hydrops fetalis. CONCLUSIONS There is a lack of consensus among obstetricians as to the CPAM characteristics that should prompt administration of prenatal steroids. Many surveyed obstetricians do not use cyst type or CVR to guide decision-making regarding steroid therapy.
A dynamical system's approach to Schwarzschild null geodesics

The null geodesics of a Schwarzschild black hole are studied from a dynamical system's perspective. Written in terms of Kerr–Schild coordinates, the null geodesic equation takes on the simple form of a particle moving under the influence of a Newtonian central force with an inverse-cubic potential. We apply a McGehee transformation to these equations, which clearly elucidates the full phase space of solutions. All the null geodesics belong to one of the four families of invariant manifolds and their limiting cases, further characterized by the angular momentum L of the orbit: for |L| > |Lc|, (1) the set that flow outward from the white hole, turn around, and then fall into the black hole, (2) the set that fall inward from past null infinity, turn around outside the black hole to continue to future null infinity, and for |L| < |Lc|, (3) the set that flow outward from the white hole and continue to future null infinity and (4) the set that flow inward from past null infinity and into the black hole. The critical angular momentum Lc corresponds to the unstable circular orbit at r = 3M, and the homoclinic orbits associated with it. There are two additional critical points of the flow at the singularity at r = 0. Though the solutions of geodesic motion and Hamiltonian flow we describe here are well known, what we believe is that a novel aspect of this work is the mapping between the two equivalent descriptions, and the different insights each approach can give to the problem. For example, the McGehee picture points to a particularly interesting limiting case of the class (1) that move from the white to black hole: in the L → ∞ limit, as described in Schwarzschild coordinates, these geodesics begin at r = 0, flow along t = constant lines, turn around at r = 2M, and then continue to r = 0. During this motion they circle in azimuth exactly once, and complete the journey in zero affine time.
A critical review of apomorphine hydrochloride sublingual film for the treatment of Parkinson’s disease ‘OFF’ episodes

Introduction: Parkinson's disease (PD) is a neurodegenerative disorder defined by its motor features. Levodopa therapy is the gold standard therapy, but over time, response is impeded by the development of motor fluctuations, including 'off' episodes where PD symptoms reemerge. Sublingual apomorphine offers a new, novel, and effective therapy developed for treatment of 'off' episodes. Areas covered: Apomorphine is an old dopamine agonist developed as a subcutaneous injectable rescue therapy for 'off' periods in PD that was approved in the United States in 2004. We will discuss its history, chemistry and clinical use. We will also cover the recent development and approval of sublingual apomorphine film that offers a novel formulation and provides effective treatment for 'off' episodes including results of the phase 3 randomized, double-blinded, placebo-controlled study. Oral mucosal side effects, which were mild to moderate and reversible in most patients experiencing them, will be discussed. Expert opinion: The new sublingual apomorphine is safe and effective for relief of 'off' periods that impact quality of life. Its ease of use will be beneficial to those with needle phobia and device challenges with currently available injectable and inhaled therapeutics. Side effect profile is an improvement from previous attempts at sublingual formulation.
A tool for patient-specific prediction of delivery discrepancies in machine parameters using trajectory log files.

PURPOSE Multileaf collimator (MLC) delivery discrepancy between planned and actual (delivered) positions have detrimental effect on the accuracy of dose distributions for both IMRT and VMAT. In this study, we evaluated the consistency of MLC delivery discrepancies over the course of treatment and over time to verify that a predictive machine learning model would be applicable throughout the course of treatment. Next, the MLC and gantry positions recorded in prior trajectory log files were analyzed to build a machine learning algorithm to predict MLC positional discrepancies during delivery for a new treatment plan. An open source tool was developed and released to predict the MLC positional discrepancies at treatment delivery for any given plan. METHODS Trajectory log files of 142 IMRT plans and 125 VMAT plans from 9 Varian TrueBeam linear accelerators were collected and analyzed. The consistency of delivery discrepancy over patient-specific quality assurance (QA) and patient treatment deliveries was evaluated. Data were binned by treatment site and machine type to determine their relationship with MLC and gantry angle discrepancies. Motion-related parameters including MLC velocity, MLC acceleration, control point, dose rate, and gravity vector, gantry velocity and gantry acceleration, where applicable, were analyzed to evaluate correlations with MLC and gantry discrepancies. Several regression models, such as simple/multiple linear regression, decision tree, and ensemble method (boosted tree and bagged tree model) were used to develop a machine learning algorithm to predict MLC discrepancy based on MLC motion parameters. RESULTS MLC discrepancies at patient-specific QA differed from those at patient treatment deliveries by a small (mean = 0.0021 ± 0.0036 mm, P = 0.0089 for IMRT; mean = 0.0010 ± 0.0016 mm, P = 0.0003 for VMAT) but statistically significant amount, likely due to setting the gantry angle to zero for QA in IMRT. MLC motion parameters, MLC velocity and gravity vector, showed significant correlation (P < 0.001) with MLC discrepancy, especially MLC velocity, which had an approximately linear relationship (slope = -0.0027, P < 0.001, R2 = 0.79). Incorporating MLC motion parameters, the final generalized model trained by data from all linear accelerators can predict MLC discrepancy to a high degree of accuracy with high correlation (R2 = 0.86) between predicted and actual MLC discrepancies. The same prediction results were found across different treatment sites and linear accelerators. CONCLUSION We have developed a machine learning model using trajectory log files to predict the MLC discrepancies during delivery. This model has been a released as a research tool in which a DICOM-RT with predicted MLC positions can be generated using the original DICOM-RT file as input. This tool can be used to simulate radiotherapy treatment delivery and may be useful for studies evaluating plan robustness and dosimetric uncertainties from treatment delivery.
Mesenchymal Stromal Cell Aging Impairs the Self-Organizing Capacity of Lung Alveolar Epithelial Stem Cells

Abstract Multicellular organisms maintain structure and function of tissues/organs through emergent, self-organizing behavior. In this report, we demonstrate a critical role for lung mesenchymal stromal cell (L-MSC) aging in determining the capacity to form 3-dimentional organoids or “alveolospheres “ with type 2 alveolar epithelial cells (AEC2s). In contrast to L-MSCs from aged mice, young L-MSCs support the efficient formation of alveolospheres when co-cultured with young or aged AEC2s. Aged L-MSCs demonstrated features of cellular senescence, altered bioenergetics, and a senescence-associated secretory profile (SASP). The reactive oxygen species generating enzyme, NADPH oxidase 4 (Nox4), was highly activated in aged L-MSCs and Nox4 downregulation was sufficient to, at least partially, reverse this age-related energy deficit, while restoring the self-organizing capacity of alveolospheres. Together, these data indicate a critical role for cellular bioenergetics and redox homeostasis in an organoid model of self-organization, and supports the concept of thermodynamic entropy in aging biology.
Effects of Parenteral Prostacyclin Therapy on Echocardiographic Variables

Purpose To evaluate the effects of treating patients with pulmonary arterial hypertension (PAH) with parenteral prostacyclin (IV/SC PGI2) therapy on echocardiographic parameters. Methods We retrospectively assessed echocardiograms of patients diagnosed with PAH by right heart catherization between 2007 and 2020. Patients were included if they had group 1 PAH with a baseline echocardiogram performed 0 - 12 months prior to starting PGI2 therapy and follow up echocardiogram performed 3 - 18 months post therapy. Comparison between the two studies was done using paired Student t-tests or Wilcoxon signed rank tests, and categorical variables were reported as percentages. Results Out of 166 patients with PAH, 122 met study criteria. Mean age was 47 ± 13, 79% were female and IPAH/HPAH (52%) and CTD-PAH (32%) were the most common diagnoses. At baseline, severe right heart abnormalities were seen. Mean RVSP was 83 ± 21, and most patients had a moderately (33%) or severely (43%) dilated RA and a moderately (32%) or severely (40%) dilated RV. Echocardiogram was performed a mean 202 ± 105 days after IV/SC PGI2 therapy was initiated. Significant improvement in most echocardiographic parameters was seen, as shown in table 1. This included improvements in RVSP, RV size, RV function and tricuspid regurgitation severity. Of note, individuals with severely diminished RV function went down from 40% to 23% (p Conclusion Given the significant changes in key echocardiographic variables after prostacyclin therapy and the non-invasive nature of these studies, echocardiograms may be useful in monitoring patient responses to prostacyclin therapies.
Clinical Importance of Microhematuria

To evaluate the etiology of microhematuria, the cases of 200 consecutive patients with asymptomatic microhematuria who had undergone complete urologic examination and two-year follow-up were reviewed. Most patients were 50 to 59 years old. Highly significant urologic lesions were found in 20% of patients. Thirteen percent of these patients had a genitourinary malignant neoplasm. No urologic lesion could be identified in 19% of patients in this group. The results suggest that present diagnostic modalities have substantially refined and improved the urologist's diagnostic abilities. The urologic examination of patients with asymptomatic microhematuria, particularly in those older than 40 years, is justified. ( JAMA 241:149-150, 1979)
A clustering analysis of energy and water consumption in U.S. States from 1985 to 2015

Abstract Energy and water are critical resources and virtually every activity that people engage in involves at least one of the two. The overall demand for energy and water in the United States has been increasing, partly as a result of population growth and changing climate conditions. In this study, we examine per capita water and energy consumption from 1985 to 2015 in all 50 states of the United States and the District of Columbia. The analysis is conducted first separately for water and energy consumption and then in a combined manner to identify the main trends and changes over the years. To further account for regional climate conditions, energy consumption data is also standardized using heating and cooling degree days. Line graphs, clustering analysis, and GIS mapping were used to analyze the data. Overall, we find that water use per capita has decreased over the years, while mixed results are found for energy consumption per capita. Moreover, some states do not show significant differences in water use or energy consumption, while others differ significantly. In general, we find that states can be clustered in five to six groups.
Strategies for Missing Data

Discusses problems induced by missing data and the multiple imputation strategies for dealing with it. Introduces and compares EM and Gaussian copula imputation methods.
Sonographic Appearance of Injection and Natural Edema in the Udder of Show Cows

Informal reports indicate that foreign materials are injected into sites of fore and rear udder attachment of show cows to augment the contour of the udder. These substances cause localized edema. This study evaluated the sonographic appearance and pattern of distribution of edema produced by subcutaneous injection with mild silver protein suspension compared to natural causes.
Contraceptive values and preferences of adolescents and young adults: A systematic review.

Abstract Objective We sought to systematically review the literature on values and preferences for contraception among adolescents and young adults globally. Study design We searched ten electronic databases for articles from January 1, 2005 through July 27, 2020 regarding end-users' values and preferences for contraception. We included studies that report specifically on people up to 25 years old. Results Fifty-five studies out of 7,846 met our inclusion criteria. These studies included participants aged 10-25 years and were conducted in 16 countries. Through open coding, we identified 18 content areas. The five most commonly discussed content areas were: (1) general preferences regarding contraception, (2) contraceptive method benefits, (3) contraceptive method drawbacks, (4) the influence of the social context, and (5) the influence of myths and misconceptions, including safety and side effects, on contraceptive choice. Privacy and autonomy were important overarching themes, along with safety of the method. These considerations affected participants’ access to and use of contraception. Conclusion Various social, cultural, and method-specific factors influence a young person's values and preferences around contraceptive methods. Understanding their values and preferences can help providers and programs improve contraceptive care for young people.
Comparison of three cisatracurium dosing strategies in acute respiratory distress syndrome: A focus on drug utilization and improvement in oxygenation.

Abstract Purpose Three continuous dosing strategies of cisatracurium (CIS) for acute respiratory distress syndrome (ARDS) have been described in the literature. After implementation of a ventilator synchrony protocol (VSP), we sought to determine which continuous CIS dosing strategy utilized the least amount of drug without compromising efficacy. Methods We retrospectively reviewed patients with ARDS receiving continuous CIS from January 1, 2013 to December 31, 2018. We categorized patients into one of three dosing strategies: fixed dose (FD), titration based solely on train-of-four (TOF), or the VSP. We documented drug consumption and determined efficacy by comparing the change in PaO2/FiO2 ratio (P/F) and oxygenation index (OI) from baseline up to 48 h. Results A total of 1047 patients were screened, and 189 met inclusion criteria (VSP = 69, TOF = 99, FD = 21). Drug consumption (mg) was significantly lower in the VSP arm: 415 [IQR 318–528] compared to both the TOF: 665 [IQR 472–927] and the FD arms: 1730 [IQR 1695–1800], p Conclusion Without impacting efficacy of gas exchange, a protocol using ventilator synchrony for CIS titration required significantly less drug compared to TOF-based titration and a fixed dosing regimen.
A Micromarketing Model

Most of the pioneers in marketing thought were either trained as economists or trained by economists, so it is somewhat of a surprise to find that very little has been done to apply econometric techniques and microeconomics to the development of marketing theory.
Nde of Fiber Reinforced Foam Composite Structures for Future Aerospace Vehicles

This slide presentation reviews the complexities of non-destructive evaluation (NDE) of fiber reinforced foam composite structures to be used for aerospace vehicles in the future.Various views of fiber reinforced foam materials are shown and described. Conventional methods of NDE for composites are reviewed such as Micro-computed X-Ray Tomography, Thermography, Shearography, and Phased Array Ultrasonics (PAUT). These meth0ods appear to work well on the face sheet and face sheet ot core bond, they do not provide adequate coverage for the webs. There is a need for additional methods that will examine the webs and web to foam core bond.
Racial Residential Segregation and Disparities in Obesity among Women

The high rate of obesity among black women in the USA is a significant public health problem. However, there is limited research on the relationship between racial residential segregation and disparities in obesity, and the existing evidence is limited and results are mixed. This study examines the relationship between racial residential segregation and obesity among black and white women. We conducted this cross-sectional study by joining data from the 1999–2004 National Health and Nutrition Examination Survey with data from the 2000 US Census. Multilevel logistic regression models found that for every one-point increase in the black isolation index, there was a 1.06 (95 % confidence interval (CI) = 1.01, 1.11) times higher odds of obesity for black women. In order to address the disparately high rates of obesity among black women, health policies need to address the economic, political, and social forces that produce racially segregated neighborhoods.