cssi/SciSciGPT-SciSciNet huggingface dataset:
Differentiating Metastatic and Non-metastatic Tumor Cells from Their Translocation Profile through Solid-State Micropores

Cancer treatment, care, and outcomes are much more effective if started at early stages of the disease. The presence of malignant cancer cells in human samples such as blood or biopsied tissue can be used to reduce overtreatment and underdiagnosis as well as for prognosis monitoring. Reliable quantification of metastatic tumor cells (MTCs) and non-metastatic tumor cells (NMTCs) from human samples can help in cancer staging as well. We report a simple, fast, and reliable approach to identify and quantify metastatic and non-metastatic cancer cells from whole biological samples in a point-of-care manner. The metastatic (MDA MB-231) and non-metastatic (MCF7) breast cancer cells were pushed through a solid-state micropore made in a 200 nm thin SiO2 membrane while measuring current across the micropore. The cells generated very distinctive translocation profiles. The translocation differences stemmed from their peculiar mechanophysical properties. The detection efficiency of the device for each type of tumor cells was ∼75%. MTCs showed faster translocation (36%) and 34% less pore blockage than NMTCs. The micropore approach is simple, exact, and quantitative for metastatic cell detection in a lab-on-a chip setting, without the need for any preprocessing of the sample.
Gaps Among Desired, Sought, and Received Support Deficits and Surpluses in Support When Coping With Taboo Marital Stressors

When faced with a taboo stressor, people might have desires for support yet feel reticent to seek assistance from others. This study contextualizes desires for support by theorizing that they are directly associated with the support people seek and indirectly associated with what they receive. There may be discrepancies among any of these perspectives, and we expand research on support gaps by considering the existence and outcomes of deficits or surpluses in the support people desire, seek, and receive. A community sample (N = 205) completed a survey regarding a taboo marital stressor. Respondents desired more support than they sought or received (i.e., support deficit) but received more support than they sought (i.e., support surplus). These discrepancies and their outcomes varied by type and source of support. Whereas deficits in support mostly decreased reappraisal of a taboo stressor, support surpluses mainly enhanced reappraisal. Implications for research on supportive communication are discussed.
Does a difference in kinesiological-function in elderly hemiplegic patients undergoing a vascular-health program have an effect on middle-finger venous-vessel width?

it in both training programs and warm-up activities. DS incorporates whole body movements and involves activity and rhythmically contracting a muscle group through part of its functional ROM. However, there is no clear distinction regarding the duration of DS activity needed to expand ROM or enhance performances. Few previous studies have compared the acute effects of SS and DS. Purpose: The purpose of this study was to examine the acute effects of SS and DS on ROM and isometric muscle strength. Methods: Fifteen healthy adults ((mean± SD) age, 27± 2.6 years) participated in this study. Knee flexion ROM at prone with hip joint maximal extension position and isometric leg extension maximal voluntary contractions at knee joint angles of 90 deg were measured. Measurements were conducted before (pre-) and after (post-) at each of two different stretching protocols and a control (CON) condition in which one minute rest was performed. The left quadriceps muscles were stretched with both SS and DS protocols. SS protocol was held for 60 seconds, and DS protocol was performed in 12 repetitions for 72 seconds (10 beats/min). A repeated measure ANOVA (pre-SS vs. pre-DS vs. preCON) was used to analyze the ROM and muscle strength data. Differences between preand post-SS, DS and CON values in ROM and muscle strength were determined with paired t tests. SPSS software (version 21.0, IBM) was used for all statistical comparisons. Results: The results of the statistical analysis indicated that ROM increased at post-SS from 139.3± 10.2 deg to 144± 8.9 deg (p< 0.01, 95%IC; 2.71–6.61), and post-DS from 142± 8.6 deg to 138± 8.9 deg (p< 0.01, 95%IC; 2.45–5.55). CON unchanged after the intervention. Muscle strength decreased at post-SS from 301.7± 92.5N to 273.8± 73.9N (p< 0.01, 95%IC; 10.2–45.6), but not in DS and CON. A repeated measure ANOVA showed that there was no difference at pre-SS, pre-DS and pre-CON values in ROM and muscle strength. Conclusion(s): These results suggested that DSmay have greater applicability to expandROMwithout decreasingmuscle strength than SS. As for the duration of DS, activity at 10 beats/min can contribute to the flexibility but not impair performance on muscular power. Implications: Using dynamic stretching may have contributed to physical therapy.
A Case of Syphilis Misdiagnosing as Scrotal Eczema

A 53-year-old male,with one-month history of a pruritic erythematous plaque,ulcer and an itchy skin on the scrotum.He had been clinically treated as scrotal eczema twice,without any improvement.The whole scrotal cutaneous flushed,with a little effusion and desquamation,also there were three soybean volume ulcer above and below the right,and its texture was little stiff without tenderness.The lymph node of the right inguinal enlarged.A Syphilis serology test revealed a reactive RPR test with a titer of 1∶4 and a positive Treponema pallidum particle agglutination(TPPA).Then treated it as primary syphilis with benzathine penicillin.A week later the ulcer scabbed,and healed completely after another week.The symptoms of scrotal skin disappeared completely.
Stimulation of apical H-K-ATPase in intercalated cells of cortical collecting duct with chronic metabolic acidosis

This study evaluated the role of H-K-adenosinetriphosphatase (H-K-ATPase) with chronic metabolic acidosis (CMA) in intercalated cells (ICs) of rabbit cortical collecting duct (CCD). CMA was induced...
Pheochromocytoma Associated with Arterial Fibromuscular Dysplasia

An unusual case of pheochromocytoma associated with multifocal medial fibromuscular dysplasia of the left subclavian (ruptured), celiac, and bilateral renal arteries is described. Additionally, the coronary arteries, left renal arcuate vessels, and peripancreatic and intracolonic muscular arteries revealed intimal fibroplasia. Thirty-three cases of pheochromocytoma associated with renal artery stenosis have been reported, including four instances radiologically attributed to fibromuscular dysplasia. Renal artery fibromuscular dysplasia associated with pheochromocytoma has not been histologically documented, and extrarenal fibromuscular dysplasia with simultaneous pheochromocytoma has not been previously described. Current etiologic concepts of fibromuscular dysplasia and possible pathogenetic mechanisms for its occurrence with pheochromocytoma are discussed.
Doubly-fed induction machine analysis for power flow control

The analysis and simulation of a doubly-fed induction machine used as a power flow control device is examined. This is a system that transfers power between one power system area and another using a doubly-fed induction machine as a rotary transformer containing rotor and stator windings. The ability to control the power flow by adjusting the rotor shaft angle is demonstrated. A test system was developed and experiments were carried out on an actual machine
Restraint stress differentially regulates inflammation and glutamate receptor gene expression in the hippocampus of C57BL/6 and BALB/c mice.

The inbred mouse strains, C57BL/6 and BALB/c have been used widely in preclinical psychiatric research. The differences in stress susceptibility of available strains has provided a useful platform ...
Spontaneous Chitin Accumulation in Airways and Age-Related Fibrotic Lung Disease

The environmentally widespread polysaccharide chitin is degraded and recycled by ubiquitous bacterial and fungal chitinases. Although vertebrates express active chitinases from evolutionarily conserved loci, their role in mammalian physiology is unclear. We show that distinct lung epithelial cells secrete acidic mammalian chitinase (AMCase), which is required for airway chitinase activity. AMCase-deficient mice exhibit premature morbidity and mortality, concomitant with accumulation of environmentally derived chitin polymers in the airways and expression of pro-fibrotic cytokines. Over time, these mice develop spontaneous pulmonary fibrosis, which is ameliorated by restoration of lung chitinase activity by genetic or therapeutic approaches. AMCase-deficient epithelial cells express fibrosis-associated gene sets linked with cell stress pathways. Mice with lung fibrosis due to telomere dysfunction and humans with interstitial lung disease also accumulate excess chitin polymers in their airways. These data suggest that altered chitin clearance could exacerbate fibrogenic pathways in the setting of lung diseases characterized by epithelial cell dysfunction.
Hand-arm vibration syndrome: A rarely seen diagnosis.

Abstract Hand-arm vibration syndrome (HAVS) is a collection of sensory, vascular, and musculoskeletal symptoms caused by repetitive trauma from vibration. This case report demonstrates how to diagnose HAVS on the basis of history, physical examination, and vascular imaging and its treatment options. A 41-year-old man who regularly used vibrating tools presented with nonhealing wounds on his right thumb and third digit. Arteriography revealed occlusions of multiple arteries in his hand with formation of collaterals. We diagnosed HAVS, and his wounds healed after several weeks with appropriate treatment. HAVS is a debilitating condition with often irreversible vascular damage, requiring early diagnosis and treatment.
Wills Act Compliance and the Harmless Error Approach: Flawed Narrative Equals Flawed Analysis?

What degree of compliance with the Wills Act formalities should the courts require when analyzing whether a will has been properly executed? The conventional wisdom is that historically courts have insisted on absolute strict compliance, favoring formalities over testamentary intent. In 1975, Prof. John Langbein argued that substantial compliance with the Wills Act formalities should suffice. A little over a decade later, he modified his proposal, arguing for a harmless error approach.Prof. Langbein’s proposals have been well received. Many academics have endorsed them. The Uniform Probate Code and the Restatement (Third) of Property have adopted his harmless error approach. Yet relatively few states have adopted either proposal. If Prof. Langbein’s substantial compliance/harmless error proposals are so much better than strict compliance, what explains the failure of most jurisdictions to adopt either of them?This article argues that (1) many of the states intuitively realize that the issue is not as simple as Prof. Langbein depicts it – that ‘strict compliance’ is neither as monolithic nor as strict as he portrays it; (2) most jurisdictions, in fact, do not apply the strict compliance approach he describes but rather a variation of it – flexible strict compliance; and (3) the real issue is not whether substantial compliance/harmless error is better than traditional strict compliance, but whether substantial compliance/harmless error is better than flexible strict compliance – and the answer to that question is far from obvious. Flexible strict compliance adopts a more pragmatic approach to the public policy considerations underlying the Wills Act formalities, eschewing the functional approach and instead favoring an approach that balances testator’s intent with costs of administration and the potential for fraud, resulting in an approach that is more efficient than either substantial compliance or harmless error.
Factors associated with epinephrine administration for anaphylaxis in children before arrival to the emergency department

Abstract Background Epinephrine is the first-line treatment for anaphylaxis but may be underused by patients and medical personnel. Objective To evaluate factors associated with anaphylaxis management before arrival at the emergency department (ED) or urgent care center (UCC). Methods We performed a retrospective review of electronic medical records for all patients aged 0 to 25 years presenting with anaphylaxis to the ED or UCC at a pediatric academic referral center during 2009 to 2013. Results A total of 408 patients (mean age, 7.25 years; 62% male) were included for analysis. Only 148 patients (36.3%) received epinephrine before arrival at the ED or UCC. Reactions occurring at home (n = 36/114) were less likely to be treated with epinephrine compared with reactions occurring at school (n = 30/49) (odds ratio [OR], 0.29; 95% confidence interval [CI], 0.15–0.59). The odds of receiving epinephrine before arrival at the ED or UCC were significantly lower with a 2-organ system (OR, 0.50; 95% CI, 0.30–0.85) or 3-organ system (OR, 0.41; 95% CI, 0.21–0.81) presentation compared with 1-organ system involvement. Foods (342 [83.8%]) were the most commonly reported provoking trigger. Patients who did not receive epinephrine before arrival at the ED or UCC were significantly less likely to be discharged to home (OR, 0.56; 95% CI, 0.37–0.86; P = .01). Conclusion This study identifies factors associated with prehospital management of anaphylaxis for children, which highlight that epinephrine administration may be occurring with considerable delay. Increased awareness and education of caregivers, patients, and medical professionals are necessary to provide optimal management.
Water Supply Infrastructure Planning: Decision-Making Framework to Classify Multiple Uncertainties and Evaluate Flexible Design

AbstractUrban planners face challenges in water infrastructure development decisions due to short-term variation in water availability and demand, long-term uncertainty in climate and population gr...
Mechanisms for the age-related increase in fatigability of the knee extensors in old and very old adults.

We show that aging of the neuromuscular system results in an increase in fatigability of the knee extensors during high-velocity exercise that is more pronounced in very old adults (≥80 yr) and occ...
Shortwave-infrared Raman spectroscopic classification of water fractions in articular cartilage ex vivo.

Water loss is an early onset indicator of osteoarthritis. Although Raman spectroscopy (RS) holds the potential for measurement of cartilage hydration, the knowledge of Raman OH-stretch bands of biological tissue is very limited. We assesed here the sensitivity of RS to identify and classify water types in the cartilage. Raman spectrum measurements over the high wavenumber range were employed to identify different water fractions in articular cartilage. Raman spectra were collected from wet and sequentially dehydrated cartilage along with pure collagen type II and chondroitin sulfate standards. OH-stretch band of cartilage is dominated by mobile water, up to 95% of total intensities. We identified six peaks in cartilage spectrum using second-derivative analysis: peaks at 3200 and 3650 cm−1 are associated with organic matrix (both collagen and proteglycan) and matrix-bound water molecules. Peaks at 3250, 3453, and 3630 cm−1 are associated with collagen and collagen-related water molecules, whereas the peak at 3520 cm−1 is associated with proteoglycan (PG) and PG-related water molecules. The current work is the first thorough analysis of the Raman OH-stretch band of the cartilage and with the knowledge generated by this study, it may now be possible to study on cartilage hydration by RS.
Mechanical Valves and the Small Aortic Annulus: Replacement Versus Root Enlargement

It is quite clear that all devices used to replace the aortic valve are at least mildly obstructive. When the aortic root is small the problem is worse. Choice of a replacement device for use in the small aortic root and the decision of whether or not to enlarge the outflow tract to accommodate a larger device are dilemmas which confront cardiac surgeons frequently.
Whiteness and Masculinity in Richard Lou's ReCovering Memphis: ReContexting Bodies

In 2016, racist, patriarchal rhetoric dominated the political landscape of the United States. As a response, activist artist Richard Lou of Memphis, Tennessee created a video piece as part of his series ReCovering Memphis titled ReContexting Bodies. In the artwork, Lou performs whiteness by re-creating photographs and reciting words of historic Civil War leaders Lieutenant General Nathan Bedford Forrest and President of the Confederate States of America Jefferson Davis. With his racialized body, Lou confronts the foundations of white supremacy in the United States American South. ReContexting Bodies examines how two historic identities of southern masculinity shape contemporary biases.
Multimedia Upstreaming Cournot Game in Non-Orthogonal Multiple Access Internet of Things

With the rapid growth of multimedia content production from massive User Equipments (UEs) in the Internet of Things (IoTs) environment, how to ensure high Quality of Experience (QoE) for UEs in the wireless IoT upstreaming services becomes a big challenge. To address the multimedia IoT QoE challenge, a game theoretical power allocation strategy is studied in the Non-Orthogonal Multiple Access (NOMA) wireless uplink IoT environment in this paper. Due to the natural non-cooperative relationships among UEs, we model the UEs’ power allocation problem in the upstreaming service as a Cournot competition game in an Oligopoly market model. In addition, factors such as the uploading content popularity, power constraints, and the energy cost of a UE are jointly considered when we build UE's QoE model. By deriving the concavity of UE's utility function, we prove the existence and uniqueness of the Nash Equilibrium power solution for each UE. Numerical simulations are carried out by considering all the system constraints in the multiple UEs scenarios. The results show that system throughput in the NOMA scheme outperforms the conventional Orthogonal Multiple Access, and the system utility performance in the proposed game solution is better than the fixed power selection strategy.
Attention, Social Interaction, and Investor Attraction to Lottery Stocks

We find that among stocks dominated by retail investors, the lottery anomaly is amplified by high investor attention (proxied by high analyst coverage, salient earnings surprises, or recency of extreme positive returns) and intense social interactions (proxied by Facebook social connectedness or population density near firm headquarters). Such stocks' lottery features attract greater Google search volume and retail net buying, followed by more negative earnings surprises and lower announcement-period returns. The findings provide insight into the roles of attention and social interaction in securities markets, and support the hypothesis that these forces contribute to investor attraction to lottery stocks.
The relation of nutrition to gastric function

Studies were made with rats of the effect of Vitamin B1 deficiency on gastric function. Following mecholyl stimulation, the volumes of gastric juice were recorded and the composition was investigated with respect to total acidity and free HCl. The experimental results indicate that acute or chronic B1 deficiencies in rats have no pathologic effect on the gastric secreting cells. Since a diminished response to gastric stimulation does not occur until the animals are moribund and the diminished response of moribund animals is promptly overcome by B1 therapy, it would appear that no serious damage to the secreting cells of the gastric mucosa occurs even with conditions of extreme deficiency.
Application of diffuse source functions for improved flow upscaling

A novel upscaling approach was previously introduced using pressure transient concepts which allowed us to distinguish between well-connected, weakly connected, and disconnected pay in the local upscaling region. The current work applies these same concepts to benchmark the upscaling formulation against existing upscaling techniques to test the impact of localization. The local flow field generated for transmissibility calculation is based on transients approaching pseudo steady state in a sub volume as opposed to steady state or pseudo steady state in the entire volume. Identification of well-connected sub volume allows us to assess the impact of localization and degree of local connectivity on overall coarse simulation performance. The upscaling step draws upon its similarity to pressure transient well testing concepts to set up local flow problems and obtain coarse transmissibilities. The concept of diffusive time of flight together with diffuse source functions allows us to assess the error in localization for a particular local flow problem. A large error in localization may require adaptive grid resolution as a possible solution by separating the well-connected and weakly connected pay. The transient methodology has also allowed us to generalize the flow diagnostics designed for incompressible flow to compressible flow. The diagnostics are used to evaluate the quality of coarsening and upscaling.
Experiential Avoidance as a Mechanism of Change Across Cognitive-Behavioral Therapy in a Sample of Participants with Heterogeneous Anxiety Disorders

Despite the substantial evidence that supports the efficacy of cognitive-behavioral therapy for the treatment of anxiety and related disorders, our understanding of mechanisms of change throughout treatment remains limited. The goal of the current study was to examine changes in experiential avoidance across treatment in a sample of participants (N = 179) with heterogeneous anxiety disorders receiving various cognitive-behavioral therapy protocols. Univariate latent growth curve models were conducted to examine change in experiential avoidance across treatment, followed by parallel process latent growth curve models to examine the relationship between change in experiential avoidance and change in anxiety symptoms. Finally, bivariate latent difference score models were conducted to examine the temporal precedence of change in experiential avoidance and change in anxiety. Results indicated that there were significant reductions in experiential avoidance across cognitive-behavioral treatment, and that change in experiential avoidance was significantly associated with change in anxiety. Results from the latent difference score models indicated that change in experiential avoidance preceded and predicted subsequent changes in anxiety, whereas change in anxiety did not precede and predict subsequent changes in experiential avoidance. Taken together, these results provide additional support for reductions in experiential avoidance as a transdiagnostic mechanism in cognitive-behavioral therapy.
An Innovative Mobile Game for Screening of Pediatric PTSD: a Study in Primary Care Settings.

Childhood is a developmental period associated with high risk of posttraumatic stress disorder (PTSD). Available validated pencil-and-paper diagnostic tools can be difficult for younger children to engage with given format and length. This study investigated psychometric properties of a briefer, more interactive game version of the Child PTSD Symptom Scale for DSM-5 (CPSS-5). Participants (n = 49) were children attending primary care appointments between 8 to 12 years of age who were exposed to a DSM-5 Criterion A trauma. Participants completed the 6-item screening version of the CPSS-5 delivered in mobile tablet game format (the CPSS-5 Screen Team Game) and a self-report version of the full CPSS-5 (CPSS-5-SR) before their medical appointments. The mobile game showed adequate internal consistency (α = 0.79), was significantly positively correlated to the total CPSS-5-SR (r = .74, p < .001, n = 49), and with the total of the six identical items of the CPSS-5-SR (r = .79, p < .001, n = 49), demonstrating good convergent validity. Receiver operating characteristic (ROC) analyses revealed a cut-off score of 9 on the screening game as indicative of probable PTSD. Implementation of this screening game into primary care settings could be a low-burden method to greatly increase the detection of pediatric PTSD for referral to appropriate integrated care interventions.
The "Look Ahead" Technique: A Novel Way to Engage Medical Students in the Radiology Reading Room.

Rationale and Objectives Engaging medical students during a radiology course can be challenging. We sought a way to actively engage students with live cases, allow them to interact with the picture archiving and communication system workstation, and experience what it is like to be a radiologist. Materials and Methods Medical students enrolled in one of three radiology courses between May 2016 and June 2017 were eligible. The “Look Ahead” technique is as follows: a preceptor identifies several nonurgent imaging studies and allows the students to view the images first and make independent observations and conclusions. When ready, the students present their findings, receive feedback, and observe the preceptor generate a final report. Students completed the postcourse survey comparing the “Look Ahead” technique with the current standard (observing a preceptor interpret imaging studies with accompanying teaching points). Results Thirty-four (56.7%) of 60 potential respondents completed the postcourse survey. Of these 34, 24 (70.6%) reported at least one reading room case (mean 4.6) in which the technique was employed, with a mean of 2.4 unique preceptors. When compared to the current standard (0 = not to 100 = very interested/engaged/valuable/memorable), the “Look Ahead” technique was associated with increased student-reported interest (92.5 vs 75.1, p Conclusion The “Look Ahead” technique is a meaningful and engaging teaching method, which students find “interesting,” “valuable,” and “memorable.”
The Relationship Between Performance of Sit-To-Stand From a Chair and Getting Down and Up From the Floor in Community-Dwelling Older Adults

The ability to perform sit-to-stand from a chair and getting down and up from the floor, or the ability to safely perform a floor transfer are important transitional activities for independent livi...
Single-Shot Spinal Anesthesia in an Infant Requiring Magnetic Resonance Imaging and Open Lower-Extremity Surgery: A Case Report

Spinal anesthesia (SA) is a safe and effective anesthetic technique for lower abdominal and lower extremity surgery in neonates and infants and is associated with an apparent state of sedation. We report the use of single-shot SA in a 6-week-old infant for a combined magnetic resonance imaging and open surgical biopsy of a deep soft tissue lower extremity mass. By leveraging the unique qualities of SA (sedation and surgical blockade), we avoided the need for general anesthesia. To our knowledge, this is the first reported use of single-shot SA for an infant undergoing two procedures in the same day. J Med Cases. 2020;11(9):286-288 doi: https://doi.org/10.14740/jmc3519
Territory Quality Predicts Avian Vocal Performance Across an Urban-Rural Gradient

Human activity around the globe is a growing source of selection pressure on animal behavior and communication systems. Some animals can modify their vocalizations to avoid masking from anthropogenic noise. However, such modifications can also affect the salience of these vocalizations in functional contexts such as competition and mate choice. Such is the case in the well-studied Nuttall’s white-crowned sparrow (Zonotrichia leucophrys nuttalli), which lives year-round in both urban San Francisco and nearby rural Point Reyes. A performance feature of this species' song is salient in territorial defense, such that higher performance songs elicit stronger responses in simulated territorial intrusions; but songs with lower performance values transmit better in anthropogenic noise. A key question then is whether vocal performance signals male quality and ability to obtain high quality territories in urban populations. We predict white-crowned sparrows with higher vocal performance will be in better condition and will tend to hold territories with lower noise levels and more species-preferred landscape features. Because white-crowned sparrows are adapted to coastal scrub habitats, we expect high quality territories to contain lower and less dense canopies, less drought, more greenness, and more flat open ground for foraging. To test our predictions, recorded songs and measured vocal performance and body condition (scaled mass index and fat score) for a set of urban and rural birds (N = 93), as well as ambient noise levels on their territories. Remote sensing metrics measured landscape features of territories, such as drought stress (NDWI), greenness (NDVI), mean canopy height, maximum height, leaf area density (understory and canopy), slope, and percent bare ground for a 50m radius on each male territory. We did not find a correlation between body condition and performance but did find a relationship between noise levels and performance. Further, high performers held territories with lower canopies and less dense vegetation, which are species-preferred landscape features. These findings link together fundamental aspects of sexual selection in that habitat quality and the quality of sexually selected signals appear to be associated: males that have the highest performing songs are defending territories of the highest quality.
Erratum: Single Mothers’ Time Preference, Smoking, and Enriching Childcare: Evidence from Time Diaries

Previous research has shown that time preference affects individuals’ market time allocation and own human capital investments. This paper uses data from the Current Population Survey-Tobacco Use Supplements, the American Time Use Survey, and the Panel Study of Income Dynamics-Child Development Supplement to examine how time preference, as measured by smoking behavior, affects mothers’ time investments in their children under age 13 and children's future test scores. The results indicate that single mothers who smoke spend significantly less time with their children in educational activities, such as reading and homework, and sharing meals with their children than non-smokers. Their children also have lower reading test scores.
Hyper-Leading in an era of Hyper-Change

It is change, continuing change, inevitable change that is the dominant factor in society today. No sensible decision can be made any longer without considering not only the world as it is, but the world as it will be. One of the key challenges for future leaders is to effectively and constructively lead change that is taking place both within organizations and in the broader social and political spheres. It is not past patterns of change that matter, it is that the nature of change is changing. As hyper-change alters the governing domain, leaders will be forced to change the ways they govern and lead – enter hyper-leaders.
Evaluation of Healthy South Texas Asthma Program on improving health outcomes and reducing health disparities among the underserved Hispanic population: using the RE-AIM model.

Background In the United States, childhood asthma prevalence is higher among low-income communities and Hispanic populations. Previous studies found that asthma education could improve health and quality of life, especially in vulnerable populations lacking healthcare access. This study aims to describe Healthy South Texas Asthma Program (HSTAP), an evidence-based asthma education and environmental modification program in South Texas, and evaluate its associations with health-related outcomes among Hispanic children with asthma and their families. Methods The RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) planning and evaluation framework was used as an overarching tool to evaluate the impact of the HSTAP. This educational program included 451 children with asthma and their families living in South Texas, an impoverished area at the Texas-Mexico border. The program consisted of (a) the asthma education (2-h) for children with asthma provided by Respiratory Therapy students at the children's schools and (b) the home visit Asthma and Healthy Homes education and walk-through sessions (at baseline and 3 months) for parents and two follow-up visits (6 and 9-12 months later) led by community health workers. The education was provided in either English or Spanish between September 2015 and August 2020 as part of the Healthy South Texas Initiative. A pre-and post-test design was implemented to assess the differences in health outcomes, knowledge, and behaviors using standardized self-reported surveys as reported by parents. Analyses included primary descriptive analyses, generalized estimating equation models, the Wilcoxon signed-rank test, and the McNemar test. Results The HSTAP was significantly associated with improved individual-level outcomes on the frequency of asthma-related respiratory symptoms, including shortness of breath, chest tightness, coughing, and sleep difficulty, among children with asthma, as well as an enhanced asthma knowledge in their family. This study also showed significant associations with children's school attendance and participation in physical activities and family social events and decreased families' worry about their asthma management. Conclusions The RE-AIM model was a helpful framework to assess the HSTAP on all its components. The results suggest that participation in an asthma education and environmental modification program was associated with improved individual-level health conditions and reduced health disparities among children with asthma in low-income communities.
Access to digital library databases in higher education: design problems and infrastructural gaps.

Background After defining accessibility and usability, the author offers a broad survey of the research studies on digital content databases which have thus far primarily depended on data drawn from studies conducted by sighted researchers with non-disabled users employing screen readers and low vision devices. Objective This article aims at producing a detailed description of the difficulties confronted by blind screen reader users with online library databases which now hold most of the academic, peer-reviewed journal and periodical content essential for research and teaching in higher education. Methods The approach taken here is borrowed from descriptive ethnography which allows the author to create a complete picture of the accessibility and usability problems faced by an experienced academic user of digital library databases and screen readers. Results The author provides a detailed analysis of the different aspects of accessibility issues in digital databases under several headers with a special focus on full-text PDF files. Conclusions The author emphasizes that long-term studies with actual, blind screen reader users employing both qualitative and computerized research tools can yield meaningful data for the designers and developers to improve these databases to a level that they begin to provide an equal access to the blind.
Bi-layer artificial muscle valves for drug delivery devices

In this paper, a "responsive drug delivery system", in which a sensor measures a marker in the patient's body and releases medication the patient requires at any given moment is developed. In this way, we can precisely control the drug concentration in patient's body to enhance drug efficiency and lessen side effects. In order to achieve responsive drug delivery, a reliable release device (e.g., a valve) has to be developed. Biocompatibility, low energy consumption, minimal and no leakage are the main requirements for such a release method
Human growth hormone release: Comparison of provocative test procedures

Abstract Twenty normal adult volunteers were systematically tested with five known provocative agents of human growth hormone (HGH) release in order to ascertain which procedure was the most effective stimulus for pituitary testing purposes. Ninety-five per cent responded normally (5 ng/ml increment) to levodopa (l-dopa) and 90 per cent to insulin-hypoglycemia. Arginine, vasopressin and glucagon were less potent stimuli; however, arginine (80 per cent response rate) was superior to vasopressin and glucagon (60 and 55 per cent, respectively). Nine subjects were retested with the same stimuli. Again, the incidence of normal HGH responses was highest with the l-dopa and insulin tolerance tests (100 and 89 per cent, respectively). Results with arginine, vasopressin and glucagon were significantly less consistent. Because of the important additional features of greater simplicity and safety, and until hypothalamic releasing substances become generally available, the routine use of l-dopa as a pituitary test agent warrants great attention.
Length of stay and long‐term mortality following ST elevation myocardial infarction

Background Over the last few decades, there has been a significant reduction in hospital length of stay (LOS) among patients undergoing percutaneous intervention (PCI) for ST elevation myocardial infarction (STEMI). Although studies have looked at predictors of long hospital stay after STEMI, the impact of LOS on long-term outcomes after PCI remains unknown. We aimed to evaluate the association between LOS at the time of index hospitalization for PCI and long-term mortality among patients presenting with STEMI. Methods We examined all patients undergoing PCI for STEMI at the Cleveland Clinic Catheterization Laboratory between 2002 and 2011. Long-term all-cause mortality was assessed using the Social Security Death Index and electronic medical record review. LOS was extracted from the discharge summary of the index hospitalization. Results A total of 1,963 patients were included in the study. Of these 1,963 patients undergoing PCI for STEMI, 126 (6.4%) died during the index hospitalization. Among survivors of this hospitalization, we observed a significant increase in long-term mortality with an increase in LOS during index hospitalization (P 10 days [HR (95% CI): 2.6 (1.6–4.3)], in comparison with patients with LOS of 1–2 days. Conclusions Long hospital stay after PCI among patients with STEMI was associated with an increased long-term mortality. A long hospital stay may be used as a marker to identify patients at higher risk for long-term mortality. © 2015 Wiley Periodicals, Inc.
From alpha to imperative code: a transformational compiler for an array-based functional language

Practical parallel programming demands that the details of distributing data to processors, as well as the details of interprocessor communication be managed by the compiler. These tasks quickly become too difficult for a programmer to do by hand, for all but the simplest parallel programs. There have been several approaches to solve this problem, however many parallel languages still require the programmer to manage much of the parallelism, and attempts at recovering parallelism from sequential programs have met with limited success. In this dissertation, I demonstrate the synthesis of parallel imperative code from algorithms written in a functional language. Functional languages implicitly support both the expression of concurrency and communication. Thus, the programmer is freed from having to explicitly manage the parallelism. A synthesizing compiler is described for a functional language called ALPHA which is a language based on systems of affine recurrence equations. ALPHA was designed to specify algorithms for regular array architectures. I show how to produce efficient code for other architectures. I discuss two problems that had to be solved before implementing the translator. The first is how to allocate 1-dimensional storage for a polyhedron, and the second is how to scan a polyhedron with nested loops. Using these tools, I demonstrate a naive translator which compiles ALPHA into imperative, but not necessarily efficient, sequential C-code. I then discuss an improved translation methodology for transforming Alpha to efficient imperative code. Using the information derived from static analysis, ALPHA can be transformed into a form suitable for generating imperative parallel code through a series of provably correct program transformations. I show that the kinds of analysis needed to generate efficient code for array based functional programs are in fact a generalization of dependency analysis, usage analysis, and scheduling techniques used in systolic array synthesis. The compilation steps described include scheduling, alignment, processor allocation, loop nest generation, and code generation.
Introduction to Surfactant Self‐Assembly

Current models and concepts are introduced and used to characterize the physical properties of homogeneous, small molecule, surfactant solutions such as the critical micelle concentration (cmc), aggregation number, degree of ionization of ionic aggregates and the interactions that determine the size and shape of aggregates, various mesophases such as spherical and rodlike micelles, lamellar, vesicular, bicontinuous, and reverse micelles, and the chemical reactivity in surfactant solutions. Surfactant aggregation is a spontaneous process and a delicate balance of forces governs the size and shapes of the structures at equilibrium. Aggregation is driven by the hydrophobic effect, the minimization of surfactant tail-water contact by transfer of the tail of the surfactant unimer from water to the aggregate core with the concomitant release of water of hydration, and an increase in the entropy of the system. Balance is provided by a combination of electrostatic, ion-specific, and hydration interactions in the interfacial region of the aggregates. Two models are generally used to interpret surfactant aggregation and solution properties, the more generally applied pseudophase model and the mass action model. For example, pseudophase models provide a comprehensive interpretation of micellar effects on chemical reactivity. A major unsolved problem is developing a general interpretation of ion-specific effects, as exemplified by the Hofmeister series on surfactant aggregate properties. The ion-pair hydration model represents one potential solution. Keywords: surfactant; unimer; micelle; microemulsion; vesicle; cmc; balance-of-forces; ion-specific effects; aggregation number; hydrophobic effect; hydration; packing parameter; catalysis; cooperativity, Hofmeister
Learning to Assess Science in Linguistically Diverse Classrooms: Tracking Growth in Secondary Science Preservice Teachers’ Assessment Expertise

Although studies have documented teachers’ growth in assessing science resulting from professional development or science methods courses, little attention has been given to growth while being prepared to assess a linguistically diverse student population. In this study, the growth of 11 secondary science preservice teachers is documented by expanding the analytical lens—looking at not only how teachers understand and plan to use assessment formatively but also their consideration of assessment design and assessment equity for English learners. Drawing on interviews, open-ended prompts, and program artifacts collected throughout the yearlong teacher education program, quantitative and qualitative findings indicate that the teachers demonstrated the most growth in their expertise at using assessment to support learning. Although quantitative analyses indicate that changes in the teachers’ expertise at designing assessment and considering equity in assessment were not statistically significant, additional analyses revealed nuanced ways in which the teachers’ expertise grew: expanding their repertoire of assessment tasks, considering alignment of assessment tasks with learning objectives, and becoming more knowledgeable of the role of language while assessing. I argue that broadening how we analyze assessment, combined with an expanded time frame, provides new information about the extent to which teachers are prepared to assess science in linguistically diverse classrooms. © 2013 Wiley Periodicals, Inc. Sci Ed 97:442–467, 2013
Controlled comparison of the BacT/Alert and BACTEC 660/730 nonradiometric blood culture systems.

In a collaborative study at three university hospitals, the recovery of microorganisms and the speed of detection of microbial growth by the BacT/Alert (Organon Teknika Corporation, Durham, N.C.) and BACTEC 660/730 (Becton-Dickinson Diagnostic Instrument Systems, Sparks, Md.) nonradiometric blood culture systems were compared. A total of 5,918 comparisons were made between BacT/Alert aerobic and BACTEC NR 6A bottles and 5,992 comparisons were made between BacT/Alert anaerobic and BACTEC NR 7A bottles. Each bottle was inoculated with 5 ml of blood. The overall recoveries of microorganisms from the two aerobic bottles were comparable; members of the family Enterobacteriaceae were recovered more often from BacT/Alert aerobic bottles alone (P less than 0.001). The overall recoveries of microorganisms from the anaerobic bottles were not significantly different. Growth of Staphylococcus aureus (P less than 0.001), coagulase-negative staphylococci (P less than 0.01), streptococci (P less than 0.001), Escherichia coli (P less than 0.01), other members of the family Enterobacteriaceae (P less than 0.02), and Pseudomonas aeruginosa (P less than 0.05) was detected earlier in BacT/Alert aerobic bottles. Growth of S. aureus (P less than 0.001), coagulase-negative staphylococci (P less than 0.05), enterococci (P less than 0.01), Streptococcus pneumoniae (P less than 0.02), viridans group streptococci (P less than 0.05), E. coli (P less than 0.001), Klebsiella pneumoniae (P less than 0.01), and other members of the family Enterobacteriaceae (P less than 0.001) was detected earlier in BacT/Alert anaerobic bottles. In a system-versus-system comparison, more gram-positive cocci were recovered from the BACTEC system alone (P < 0.05), and more members or the family Enterobacteriaceae were recovered from the BacT/Alert system alone (P < 0.001). As a system, the BacT/Alert system detected growth of S. aureus (P < 0.001), coagulase-negative staphylococci (P < 0.01), streptococci (P < 0.001), E. coli (P < 0.001), other members of the familyEnterobacteriaceae (P < 0.001), and P. aeruginosa (P < 0.05) earlier than the BACTEC system did. Significantly fewer (40 versus 1,183) false-positive results occurred with the BacT/Alert system. We conclude that the BacT/Alert and BACTEC 660/730 nonradiometric systems are comparable for recovering clinically significant microorganisms form adult patients with bacteremia or fungemia, but that the BacT/Alert system detects microbial growth earlier than the BACTEC system does, with significantly fewer false-positive results.
Moral Courage in Practice: Implications for Patient Safety

This descriptive correlational study examined moral courage in response to a threat to patient safety. A mailed questionnaire was randomly distributed to Midwest perioperative registered nurses. Multiple regression analysis results indicate that the moral courage in perioperative nurses is significantly influenced by education level, certification, peer support, institutional culture and Magnet® designation, fear of reprisal and retaliation, and previous operating room experience. Significant findings clustered influencing factors of fear, previous experience, peer support, and institutional culture. Future research is indicated for supportive nursing management and policy creation promoting moral courage in situations that threaten patient safety in the perioperative area.