cssi/SciSciGPT-SciSciNet huggingface dataset:
US campus fraternities and sororities and the young adult injury burden.

Objective To investigate whether the presence of fraternities and sororities was associated with a higher local injury rate among undergraduate-age youth. Methods In 2016 we compared the rate of 2010-2013 youth (18-24 years) emergency department (ED) visits for injuries in Hospital Service Areas (HSA) with and without fraternities and sororities. ED visits were identified in the State Emergency Department Database (n=1,560 hospitals, 1,080 HSAs, 16 states). US Census Bureau and National Center for Education Statistics sources identified HSA population and campus (n=659) characteristics. A proprietary database identified campuses with fraternities and sororities (n=287). ED visits explicitly linked to fraternities and sororities in the National Electronic Injury Surveillance System-All Injury Program were used to identify injury causes for sub-group analysis. Results HSAs serving campuses with fraternities and sororities had lower age 18-24 injury rates for all causes except firearm injuries (no difference). Conclusions Fraternities and sororities were not associated with a higher injury rate at the population level among undergraduate-age youth. A major limitation is not being able to observe campus health services utilization.
Gender Based Differences in Discriminatory Questions Asked of Urology Applicants during Residency Interviews

AbstractIntroduction:Interviews are essential to the residency application process. Questions regarding marital status, childbearing, ethnicity and religion violate employment law if asked by the i...
Gonadal function, sexual behavior, feedlot performance, and carcass traits of ram lambs actively immunized against GnRH.

The effect of active immunization against GnRH on production, carcass, and behavioral traits was examined in ram lambs fed to a uniform slaughter weight. Lambs (initial BW = 32.6+/-1 kg) were stratified by BW and assigned at random to one of four treatment groups (n = 12 lambs/group). Lambs were untreated, castrated, or actively immunized against GnRH using a GnRH-keyhole limpet hemocyanin conjugate (1 mg) emulsified with either Freund's complete adjuvant (FCA) or another oil-based adjuvant (ISA). Animals were housed individually and slaughtered at 58 kg BW. Immunoneutralization of GnRH reduced (P < .05) testes weight and the concentration of testosterone in serum at slaughter. Suppression of testicular size and function was most clearly evident in animals immunized using FCA. Final anti-GnRH titer was also highest in lambs immunized using FCA. Several measures of sexual behavior (frequency of mounts and ejaculations) were also reduced (P < .05) in animals immunized using FCA. The duration of the feeding period was greater (P < .05) for castrated lambs than for untreated lambs, and intermediate feeding periods were required for FCA and ISA lambs. Average daily gain was greater (P < .05) in untreated than in castrated, FCA, or ISA lambs. Similarly, feed efficiency for untreated lambs was greater (P < .05) than for castrated, FCA, or ISA lambs, but feed efficiency did not differ among castrated, FCA, or ISA lambs. Longissimus muscle area, lean and bone maturity, overall quality, muscling score, flank streaking, and color of fat did not differ among treatments. Intact, FCA, and ISA lambs had more (P < .05) desirable yield grades, less (P < .05) backfat, and less (P < .05) marbling than castrated lambs. In summary, immunization against GnRH decreased testicular weight and reduced (P < .05) feedlot performance and sexual behavior to levels comparable to those of castrated males. Partitioning of nutrients for growth and deposition of fat, however, seems to differ among immunologically castrated and physically castrated lambs. This difference in nutrient partitioning may be due to residual testicular activity in immunized lambs.
The Legal Writing Companion: Problems, Solutions, and Samples

The Legal Writing Companion is a practical, helpful guide for the new legal writer, designed to address common problems and demonstrate how and why to make effective choices to solve them. The book is intended as an assigned supplement to a legal research and writing textbook or as a handbook for students working independently to strengthen their legal writing. Based on the authors’ combined twenty years of experience teaching legal research and writing, the book addresses the novice legal writer and offers specific tools for moving forward from the very first day of class (e.g., Problem: I’m Intimidated by Legal Writing) to polishing a final written work product (e.g., Problem: I’m Having Trouble with Tone).Organized by eight common “problem” areas, the book uses a fictional case file to work through a series of problems and includes samples of both strong and weak writing choices. Chapters 1-3 identify and discuss common challenges during the prewriting stage, including the transition to writing a full first draft. Chapters 4-6 focus on organizing legal analysis, writing and explaining legal rules, and applying law to facts. Chapter 7 discusses problems and solutions related to the smaller components of legal writing, and Chapter 8 troubleshoots common polishing errors, from overuse of legalese to common citation problems. There are also two complete annotated memos in the Appendices to pull together the themes presented in the text and show multiple models of successful finished products. Early reviewers responded overwhelmingly positively, wishing they’d had the book as a first-year legal writer.
Complication rates of resident-performed cataract surgery: Impact of early introduction of cataract surgery training.

Purpose To determine the effect of the early introduction of cataract surgery training on the complication rates of resident-performed cataract surgery. Setting University of California San Diego, San Diego, California, USA. Design Retrospective case series. Methods Two classes of ophthalmology residents were examined, one class with a late introduction of cataract surgery and one with an early introduction of cataract surgery. All cataract cases in which residents acted as primary surgeon were included. Patient charts were reviewed to collect data on patient characteristics, surgical details, and intraoperative and postoperative complications. Results The late-introduction cohort comprised 3 residents who performed 540 cataract cases, all during their final year of residency. The early-introduction cohort comprised 4 residents who performed 780 cataract cases beginning in the first year of residency. The late-introduction cohort had higher rates of major intraoperative complications than the early-introduction cohort (8.5% versus 3.1%) and of anterior vitrectomy (7.6% versus 2.1%) (both P Conclusions Early introduction of cataract surgery training significantly decreased the rate of major intraoperative complications, specifically anterior vitrectomy, in resident-performed cataract surgeries.
A Nanopipette Platform for Delivering Nanoliter Volumes of Acetylcholine

Delivery of nano-liter volumes of neurotransmitter is important in fundamental studies to understand the brain function, as well as in pharmacological intervention for the treatment of neurological disorders. We present here a nanopipette based electrochemical delivery platform for the delivery of acetylcholine, and the measurement of the delivered acetylcholine concentration profile following its delivery. The delivery was enabled by the applied voltage and nano-liter volumes (1.342 ± 0.417 nL) of acetylcholine was successfully delivered. An acetylcholine sensing electrode was used to monitor the acetylcholine concentration in the cellular environment immediately following its delivery, based on the ion transfer across the interface between two immiscible electrolyte solutions (ITIES). Parameters that affect the delivery process were investigated and it was unveiled that both the applied voltage duration and voltage magnitude affect the acetylcholine delivery into the cellular medium. The presented nanoliter delivery platform has advantages of easiness to fabricate, low cost, and flexibility to be positioned over different types of cellular structure.
HISDAC-US, historical settlement data compilation for the conterminous United States over 200 years

Human settlement plays a key role in understanding social processes such as urbanization and interactions between human and environmental systems but not much is known about the landscape evolution before the era of operational remote sensing technology. In this study, housing and property databases are used to create new gridded settlement layers describing human settlement processes at fine spatial and temporal resolution in the conterminous United States between 1810 and 2015. The main products are a raster composite layer representing the year of first settlement, and a raster time series of built-up intensity representing the sum of building areas in a pixel. Several accompanying uncertainty surfaces are provided to ensure the user is informed about inherent spatial, temporal and thematic uncertainty in the data. A validation study using high quality reference data confirms high levels of accuracy of the resulting data products. These settlement data will be of great interest in disciplines in which the long-term evolution of human settlement represents crucial information to explore novel research questions. Machine-accessible metadata file describing the reported data (ISA-Tab format)
Penumbra Occlusion Device for neurovascular vessel sacrifice: Feasibility and application.

Abstract Purpose The purpose of this study is to describe the use of the Penumbra Occlusion Device (POD), which is a coil with an enhanced anchor segment, along with standard coils for carotid and vertebral artery sacrifice, and to assess its feasibility, safety, and efficacy. Methods This is a retrospective chart review of patients with vessel sacrifices who were treated using POD. For the procedure, a balloon test occlusion was performed prior to permanent arterial sacrifice. Following this, a POD was deployed followed by subsequent angiography to confirm occlusion. Secondary PODs or standard coils were deployed as necessary. Results A total of 5 internal carotid arteries and 5 vertebral arteries were treated in 10 patients. The mean vessel diameter of the vessel sacrificed was 4 mm (range 2.9–7.7 mm). The total mean number of coils required for vessel sacrifice was 7 (range 3–17). The mean number of PODs used for vessel sacrifice was 2.4 (range, 1–6). The mean number of additional standard coils used was 4.1 (range, 0–13). 9/10 (90%) parent arteries were successfully occluded. One patient had slow flow distal to the occluded segment. One (10%) of the patients had a delayed ischemic event. There were no immediate periprocedural complications including coil migrations or vessel dissections. 6/10 patients had follow-up imaging and no patients developed recanalization during the follow-up period. Conclusion Parent vessel sacrifice using a combination of PODs and standard coils appear to be a feasible, safe and effective alternative to the traditional vessel sacrifice techniques.
Repeat aortic valve replacement for failing aortic root homograft.

Abstract Objective Published data are limited in comparison of transcatheter aortic valve replacement with surgical aortic valve replacement for the failing aortic root homograft. We reviewed our experience with repeat aortic valve replacement in failing aortic root homografts to compare outcomes of transcatheter aortic valve replacement and surgical aortic valve replacement. Methods We retrospectively reviewed the records of 51 patients with failing aortic root homografts who received repeat aortic valve replacement between October 2000 and May 2018. Operation included transcatheter aortic valve replacement in 11 patients between June 2014 and May 2018. Surgical aortic valve replacement was performed in 40 patients between October 2000 and January 2018, and operation included repeat composite aortic valve/root replacement in 30 patients (75%). Results Patient age was 59 years (interquartile range, 50-72 years), sex was female in 9 patients (18%), and time to repeat aortic valve replacement was 12 years (interquartile range, 8-13). Procedure-related complications occurred in 37 patients (73%): vascular injury (any) more commonly in the transcatheter aortic valve replacement group (36% vs 5%; P = .015), bleeding (major or life-threatening) more commonly in the surgical aortic valve replacement group (58% vs 0%; P Conclusions Repeat aortic valve replacement for failing aortic root homograft is associated with notable risk of morbidity and mortality regardless of replacement technique. Avoidance of vascular injury could lead to improved outcomes in the transcatheter aortic valve replacement group.
Urban Development in India: Global Indians in the Remaking of Kolkata

Indian diaspora has had a complex and multifaceted role in catalyzing, justifying and promoting a transformed urban landscape in India. Focussing on Kolkata/ Calcutta, this book analyses the changing landscapes over the past two decades of one of the world’s most fascinating and iconic cities. Previously better known due to its post-Independence decline into overcrowded poverty, pollution and despair, in recent years it has experience a revitalization that echoes India’s renaissance as a whole in the new millennium. This book weaves together narratives of migration and diasporas, postmodern developmentalism and neoliberal urbanism, and identity and belonging in the Global South. It examines the rise of middle-class environmental initiatives and Kolkata’s attempts to reclaim its earlier global status. It suggests that a form of global gentrification is taking place, through which people and place are being fundamentally restructured. Based on a decade’s worth of field research and investigation in multiple sites - metropolitan centers connected by long histories of empire, migration, economy, and culture - it employs a multi-methods approach and uses ethnographic, semi-structured interviews as well as archival research for much of the empirical data collected. Addressing urban change and policies, as well as spatial and discoursive transformations that are occurring in India, it will be of interest to researchers in the field of urban geography, urban and regional planning, environmental studies, diaspora studies and South Asian studies.
A meta-analytic review of personality traits and their associations with mental health treatment outcomes.

Abstract Personality traits have been hypothesized to be clinically useful for diagnosis, client conceptualization, treatment planning, as well as for predicting treatment outcomes. Although several studies examined the relation between personality traits and specific therapy outcomes, this literature has not yet been systematically reviewed. Thus, the purpose of the current study was to investigate the relations between personality traits and various therapeutic outcomes. Traits were organized via the domains of the five-factor model to provide a common framework for interpreting effects. Across 99 studies (N = 107, 206), overall findings indicated that traits were systematically related to outcomes, with many specific relations congruent with theorized predictions. Generally, lower levels of neuroticism and higher levels of extraversion, agreeableness, conscientiousness, and openness were associated with more favorable outcomes. More specifically, agreeableness had positive associations with therapeutic alliance and conscientiousness was positively related to abstinence from substances suggesting these traits are likely a beneficial factor to consider at the outset of services. Personality traits also related to various outcomes differently based on moderators. For example, duration of treatment moderated links between traits and outcomes suggesting these effects are amplified over longer services. Overall results suggest that personality assessment can aid with case conceptualization by suggesting potential strengths as well as barriers to treatment.
Toward the Mott state with magnetic cluster formation in heavily Cu-doped NaFe1−xCuxAs

Recent neutron-scattering measurements indicate that ${\mathrm{NaFe}}_{1\ensuremath{-}x}{\mathrm{Cu}}_{x}\mathrm{As}$ forms an antiferromagnetic stripe phase near $x\ensuremath{\approx}0.5$ in a Mott insulating state. This copper concentration is well in excess of that required for superconductivity, $xl0.04$. We have investigated the development of magnetism in this compound by using $^{23}\mathrm{Na}$ nuclear magnetic resonance (NMR) spectra and spin-lattice relaxation measurements performed on single crystals ($x=0.13$, 0.18, 0.24, and 0.39). We find multiple inequivalent Na sites, each of which is associated with a different number of nearest-neighbor Fe sites occupied by a Cu dopant. We show that the distribution of Cu substituted for Fe is random in-plane for low concentrations ($x=0.13$ and 0.18) but deviates from this with increasing Cu doping. As is characteristic of many pnictide compounds, there is a spin pseudogap that increases in magnitude with dopant concentration. This is correlated with a corresponding increase in orbital NMR frequency shift, indicating a change in valence from ${\mathrm{Cu}}^{2+}$ to a ${\mathrm{Cu}}^{1+}$ state as $x$ exceeds 0.18, concomitant with the change of ${\mathrm{Fe}}^{2+}$ to ${\mathrm{Fe}}^{3+}$ resulting in the formation of magnetic clusters. However, for $x\ensuremath{\le}0.39$ there is no evidence of long-range static magnetic order.
Chronic Systemic Inflammation Is Associated With Symptoms of Late-Life Depression: The ARIC Study.

Abstract Objective The current study examined how the pattern of systemic inflammation in the decades leading up to late-life relates to depression symptoms in older adults. Methods Within the Atherosclerosis Risk in Communities Study, we measured high-sensitivity C-reactive protein (CRP), a nonspecific marker of systemic inflammation, at three visits: 21 years and 14 years before, and concurrent with the assessment of depression symptoms, defined using the 11-item Center for Epidemiologic Studies Depression (CESD) scale. We categorized participants into one of four groups based on their 21-year longitudinal pattern of elevated (≥3 mg/L) versus low ( Results A total of 4,614 participants were included (age at CESD assessment: 75.5 [SD: 5.1]; 59% female; follow-up time: 20.7 years [SD: 1.0]). Compared to participants who maintained low CRP levels (stable low), participants who had elevated CRP at two of three visits (unstable elevated; s = 0.09; 95% confidence interval [CI]: 0.02, 0.17) and participants who maintained elevated CRP at all three visits (stable elevated; s = 0.13; 95% CI: 0.05, 0.21) had greater depression symptoms as older adults, after adjusting for confounders. After excluding participants with late-life cognitive impairment, only participants with stable elevated CRP demonstrated significantly greater late-life depression symptoms. In a secondary analysis, stable elevated CRP was associated with increased risk for clinically significant late-life depression symptoms. Conclusion Chronic or repeated inflammation in the decades leading up to older adulthood is associated with late-life depression, even in the context of normal cognition.
First encounter with robot Alpha: How individual differences interact with vocal and kinetic cues in users’ social responses:

The Computers are Social Actors (CASA) paradigm was proposed more than two decades ago to understand humans’ interaction with computer technologies. Today, as emerging technologies like social robo...
Control of plant height by 24 alleles at 12 quantitative trait loci in rice

Abstract Plant height (PH) is controlled by quantitative trait loci (QTLs) in rice. In the present study, a recombinant inbred line population developed by crossing two rice cultivars, Lemont and Yangdao4, was grown in eight environments for QTL analysis. Multiple interval mapping detected 53 PH-QTLs, 39 of which clustered at 12 chromosome regions/putative loci. An examination of the 12 putative loci identified 24 alleles that are simultaneously involved in controlling PH. Linear regression analyses suggested that these 24 alleles function additively across the 12 loci to control PH, and plants carrying more PH-increasing alleles at the 12 loci were taller than those carrying more PH-decreasing alleles. Multiple comparison tests indicated that the effect of a single allele at the 12 loci was small and that multiple alleles must be pyramided to attain a statistically significant effect. The closest markers to the 12 loci can be used directly in marker-assisted breeding to manipulate PH.
Treatment patterns and outcomes in goblet cell carcinoid tumors of the appendix.

BACKGROUND Goblet cell carcinoid (GCC) tumors of the appendix are a rare malignancy. We aim to examine the overall survival per stage and the relationship between different treatment modalities and outcomes for patients with GCC tumors of the appendix. METHODS We identified patients with GCC tumors of the appendix from the National Cancer Database. The main outcome was overall patient survival and cox proportional hazard models were used to ascertain predictors of survival. RESULTS There were 2552 patients identified. The median age of diagnosis was 57 (interquartile range: 49-65) and 52.3% of patients were female. The 5-year survival for Stage I disease was 91.1% (95% confidence interval [CI]: 82.2%-95.7%), for Stage II disease was 90.5% (95% CI: 85.8%-93.7%), for Stage III disease was 57.0% (95% CI: 45.0%-67.3%), and for Stage IV disease was 18.9% (95% CI: 9.3%-31.0%). In a Cox proportional hazard model, older age (hazard ratio [HR]: 1.1; 95% CI: 1.03-1.12; P < .001), lymph node metastasis (HR: 6.9; 95% CI: 2.76-17.01; P < .001), and positive surgical margins (HR: 2.9; 95% CI:1.13-7.26; P = .003) were associated with worse overall survival for Stages I to III disease while only older age (HR: 1.03; 95% CI: 1.002-1.06; P = .04) was associated with worse overall survival for Stage IV disease. CONCLUSIONS Patients with GCC tumors of the appendix who have the nonmetastatic disease have a high 5-year survival. We have identified several prognostic factors for GCC.
A cluster analysis of text message users based on their demand for text messaging: A behavioral economic approach

The goal of this study was to determine whether cluster analysis could be used to identify distinct subgroups of text message users based on behavioral economic indices of demand for text messaging. Cluster analysis is an analytic technique that attempts to categorize cases based on similarities across selected variables. Participants completed a questionnaire about mobile phone usage and a hypothetical texting demand task in which they indicated their likelihood of paying an extra charge to continue to send text messages. A hierarchical cluster analysis was conducted on behavioral economic indices, such as demand intensity, demand elasticity, breakpoint, and the maximum expenditure. With the cluster analysis, we identified 3 subgroups of text message users. The groups were characterized by (a) high intensity and low elasticity, (b) high intensity and medium elasticity, and (c) low intensity and high elasticity. In a demonstration of convergent validity, there were statistically significant and conceptually meaningful differences across the subgroups in various measures of mobile phone use and text messaging. Cluster analysis is a useful tool for identifying and profiling distinct, practically meaningful groups based on behavioral indices and could provide a framework for targeting interventions more efficiently.
Mechanism for neurotransmitter-receptor matching

Synaptic communication requires the expression of functional postsynaptic receptors that match the presynaptically released neurotransmitter. The ability of neurons to switch the transmitter they release is increasingly well documented, and these switches require changes in the postsynaptic receptor population. Although the activity-dependent molecular mechanism of neurotransmitter switching is increasingly well understood, the basis of specification of postsynaptic neurotransmitter receptors matching the newly expressed transmitter is unknown. Using a functional assay, we show that sustained application of glutamate to embryonic vertebrate skeletal muscle cells cultured before innervation is necessary and sufficient to up-regulate ionotropic glutamate receptors from a pool of different receptors expressed at low levels. Up-regulation of these ionotropic receptors is independent of signaling by metabotropic glutamate receptors. Both imaging of glutamate-induced calcium elevations and Western blots reveal ionotropic glutamate receptor expression prior to immunocytochemical detection. Sustained application of glutamate to skeletal myotomes in vivo is necessary and sufficient for up-regulation of membrane expression of the GluN1 NMDA receptor subunit. Pharmacological antagonists and morpholinos implicate p38 and Jun kinases and MEF2C in the signal cascade leading to ionotropic glutamate receptor expression. The results suggest a mechanism by which neuronal release of transmitter up-regulates postsynaptic expression of appropriate transmitter receptors following neurotransmitter switching and may contribute to the proper expression of receptors at the time of initial innervation.
Ebselen nanoemulgel for the treatment of topical fungal infection

Abstract Superficial mycoses are the fungal infections of skin, hair and nail which affect thousands of people worldwide. Emerging resistance to azole antifungals is a common problem in the treatment of superficial or systemic fungal infection. Ebselen (EB), an organoselenium compound, has demonstrated promising activity against pathogenic yeasts. EB showed negligible dynamic and kinetic solubility in water (~ 4.2 µg/mL) which severely limits the scope of conventional formulations. The objective of present study was to develop and characterize a novel topical nanoemulgel of EB for enhancing solubility and permeability. Based on saturation solubility study, EB loaded self-nanoemulsifying preconcentrate (EB-P) was prepared using Dimethylacetamide, Kolliphor® ELP and Medium chain triglyceride which spontaneously formed 54.82 ± 1.26 nm size nanoglobules with zeta potential of -1.69 mV. Nanoemulgel was prepared by homogenous dispersion of EB-P in various gel/ointment bases. Scanning electron microscopy images showed significant drug precipitation in nanoemulgels prepared without Soluplus®. Rheological study confirmed shear thinning behavior of Soluplus® based HPMC K4M (SBH) gel. EB-P loaded SBH showed 2.3 and 5-fold higher Strat-M® deposition of EB compared to HPMC gel and Aquaphor®, respectively. EB-P showed marked anti-fungal activity at 20 µM against Candida albicans and Candida tropicalis while terbinafine was ineffective even at 100 µM concentration. Thus, topical nanoemulgel of EB could be a promising alternative to existing therapy for treatment of candidiasis.
Adaptive nonparametric regression on finite support

In this paper, we propose an adaptive nonparametric regression estimation procedure when the covariate is supported over a finite interval. Unlike the classical symmetric kernel regression, the pro...
Geometrical modeling of tow wrinkles in automated fiber placement

Abstract This paper presents a thorough investigation of wrinkling within a path on a general surface for a composite tow constructed using the AFP process. Governing equations and assumptions for the presented model are derived based on geometrical considerations. A simple form of the wrinkled shape is assumed and applied to the inner edge of the tow path. For a given wavelength, the amplitude of the wrinkles can be approximated based on a worst-case scenario where all the difference in length between the edges of the path is absorbed through an out-of-plane wrinkle. The wrinkle wavelength can be obtained either from existing mechanics models in the literature or experimental measurements, otherwise an adequate wavelength can be assumed. A numerical solution is implemented to visualize wrinkles on the curved paths and to indicate potential regions for wrinkling on the surface. Several examples are presented to demonstrate the model, including constant angle paths on a double-curved surface and curved paths on a flat surface. From a geometrical standpoint, increasing the tow width or the path curvature results in an increase in the wrinkles’ amplitude. Calculation of the wrinkles’ amplitude for a steered path on flat surface shows good agreement with experimental measurements.
Role of intravenous acetaminophen in pediatric anterior cruciate ligament reconstruction

Abstract Background Intravenous acetaminophen is used as part of a multimodal analgesia regimen for a variety of surgical procedures. In 2015, we implemented a standardized clinical management guideline for patients undergoing anterior cruciate ligament reconstruction. In this study we investigate the clinical impact of intravenous acetaminophen in pediatric patients undergoing arthroscopic anterior cruciate ligament reconstruction managed with and without intravenous acetaminophen. The primary hypothesis of this study was that patients managed with intraoperative intravenous acetaminophen would require less total in-hospital opioid medications. Methods In this retrospective cohort study, we compared all patients aged 10 to 21 years of age who underwent arthroscopic anterior cruciate ligament reconstruction at any of the Children's Hospital of Philadelphia locations between December 1, 2015 and November 30, 2017. The patients were grouped based on the administration of an intraoperative dose of intravenous acetaminophen (Group A) or those managed without intraoperative intravenous acetaminophen (Group B). Results We identified 318 patients who underwent an arthroscopic anterior cruciate ligament reconstruction. Patients were similar in age, gender, weight, and duration of surgery. When we grouped the patients based on location of surgery (main hospital vs. ambulatory surgery center), we found that the dose of total in-hospital opioid was not significantly different between the Group A and Group B at the main hospital [difference of mean (95% CI) 0.013 (-0.005, 0.032), p = 0.16); and at the ambulatory surgery center [difference of mean (95% CI) 0.002 (-0.008, 0.011), p = 0.99). Conclusions In this cohort, we found that the addition of intravenous acetaminophen to a multimodal pain regimen for anterior cruciate ligament reconstruction surgery is not associated with a reduction in total in-hospital opioid use. This finding may be related to the concomitant use of peripheral nerve blocks and intravenous ketorolac.
Experience with Liposomal Amphotericin B in Outpatient Parenteral Antimicrobial Therapy.

Outpatient parenteral antimicrobial therapy (OPAT) is a safe, effective, and convenient treatment strategy for patients receiving intravenous antimicrobials in the outpatient setting; however, data are limited describing the use and safety of liposomal amphotericin B (L-AMB). Records of patients receiving L-AMB OPAT between 1/1/2015 and 7/31/2018 were retrospectively reviewed. The primary objective was to describe the OPAT patient population discharged on L-AMB and evaluate factors associated with readmission and adverse events (AEs). Analysis was performed to evaluate for predictors of worse outcomes. Forty-two patients (67% male, median age 50 years) were identified, most of whom were treated for histoplasmosis. The most common doses of L-AMB were 3 mg/kg (n = 16, 38%) or 5 mg/kg (n = 14, 33%) based on actual body weight. Twenty-six (62%) patients completed their anticipated course of L-AMB. Twenty-two (52%) patients were readmitted within 30 days of discharge; median time to readmission was 11 days (interquartile range [IQR] 5 to 18). While hypokalemia and acute kidney injury (AKI) were common, occurring in 26 (62%) and 20 (48%) patients, respectively, only 5 (12%) were readmitted to the hospital due to L-AMB-associated AEs. Ninety percent of patients achieved at least partial renal recovery within 30 days after L-AMB discontinuation. Factors significantly associated with AKI include higher L-AMB dose, lower serum potassium levels after therapy initiation, and receipt of potassium supplementation at discharge. L-AMB is associated with significant AEs; however, these results suggest that treatment is feasible in the outpatient setting with close monitoring, as the majority of AEs were managed effectively in an outpatient without long-term sequelae.
Current mood influences biases for positive and negative stimuli

Altered attentional biases for emotional information are observed in populations with mood-related disorders. However, studies of emotion-related attentional biases in general populations have inconsistent findings. Inconsistencies may partially result from the use of average reaction time (RT) as a measure of attentional bias, which does not account for the RT distribution’s skewness or individual differences that influence RT but are unrelated to attention. 118 participants completed a word-based emotional flanker task and questionnaires on current mood, emotion regulation, and attention control. Participants responded more slowly, but more accurately, to negative than positive target trials. Applying the diffusion model to the data revealed an attentional bias (measured by drift rates) for negative over positive stimuli and an initial bias (measured by starting point) to positive responses overall. Furthermore, increased negative mood was associated with decreased attention control across all trials, though the relationship became anecdotal when participants with clinical levels of depressive symptoms were excluded. This study helps elucidate how current mood affects attentional biases towards emotional information in a general population and may contribute to research on altered attentional biases in mood-related psychiatric disorders.
Outcomes in Laparoscopic Roux-en-Y Gastric Bypass and Implications for Surgical Resident Education

Objectives Some surgery residents feel inadequately prepared to perform advanced operations, partly due to losing operative opportunities to fellows. In turn, they are prompted to pursue fellowships. Allowing residents the opportunity to participate in advanced procedures and complex cases may alleviate this cycle, if their participation is safe. This study examined the effects of resident participation in laparoscopic Roux-en-Y gastric bypass procedures (LRYGBs). Design Our MBSAQIP database was used to identify LRYGBs performed at our institution between 2015 and 2018. Operative notes were reviewed to determine training level of the assistant. Patient comorbidities and outcomes (duration of surgery, length of stay, post-operative complications, readmissions, and reoperations) were stratified by assistant level of training for comparison. Setting Urban tertiary care hospital. Participants Trainees and attending surgeons acting as assistants during LRYGBs. Results Among 987 total cases, the assistants for the procedures were chief residents (n = 549, 56%), fourth-year residents (n = 258, 26%), attending surgeons (n = 143, 14%), and third-year residents (n = 37, 4%). Attending surgeons assisted more often when patients had a BMI ≥ 45 (38% attendings vs. 25% residents, p = 0.007), ≥ 2 comorbidities (54% vs. 40%, p = 0.007), or had a history of prior bariatric surgery (22% vs. 3%, p Conclusion Complication rates, hospital length of stay, readmission rates, and reoperation rates were equivalent for patients regardless of the level of training of the assistant for LRYGBs. Involving residents in complex bariatric procedures such as LRYGB is a safe model of education that does not compromise patient safety or hospital outcomes. Involvement in advanced cases allows general surgery residents to more confidently move toward independent practice.
Seduced by the West: Jefferson's America and the Lure of the Land Beyond the Mississippi

In her provocative new book, Laurie Winn Carlson questions the larger aims of the famed Lewis and Clark expedition of 1804-1806 and sees it as part of a broad range of schemes to wrest the American West from the claims of established European powers. If American ships were already plying the waters off the Pacific Northwest coast, why, Ms. Carlson asks, was it necessary to send these two intrepid explorers overland-except as a demonstration of American reach, and perhaps as a ploy to tempt the Spanish to attack the expedition, thus provoking a war with Spain in Florida and the West. Ms. Carlson views the Lewis and Clark expedition as just one of several schemes to seize Western lands from foreign powers and extend the new United States to the Pacific. And behind the scenes in most all of them was the Virginian who actually knew little about the region but under whose presidency the Louisiana Purchase was completed, Thomas Jefferson. As Ms. Carlson notes, Jefferson never traveled west, but he was involved to varying degrees with men who did the exploring, organizing, and trekking at the Western frontiers-men who left few papers for historians to pursue and have been largely forgotten. Seduced by the West investigates the wide range of players in this drama of intrigue and possibilities. Russia, Spain, England, and France all tried to explore the West, and all for different reasons. Only one nation succeeded, but as Ms. Carlson shows, it was not always a simple task-or even an intended one.
The subliminal psychodynamic activation method: comprehensive listing update, individual differences, and other considerations

Publisher Summary This chapter reviews the subliminal psychodynamic activation method. Personality differences among individuals when engaging in clinical research are implicit in psychoanalytic theory. In addition to assessing a particular pathology, the assessment of subject characteristics (such as the presence of anaclitic or introjective proclivities) makes it possible to demonstrate subliminal psychodynamic activation effects. Responsiveness to the activation of particular psychodynamic motives are dependent not only on membership in groups with particular primary designations—for example, schizophrenics—but also on subgroup characteristics, such as whether the schizophrenics are relatively differentiated or undifferentiated; are men or women; or are relatively well defended or undefended against disturbing ideation. Various conditions that need to be fulfilled to maximize the chances of finding subliminal psychodynamic activation effects include (1) alerting oneself to conditions that could interfere with subliminal registration; (2) providing a high “dosage” of subliminal psychodynamic activation (both in terms of frequency and duration) whenever possible; and (3) employing verbal and pictorial stimuli together whenever feasible.
Additives for middle distillate and kerosine fuels

The benefits achievable from stabilizer additives and the effects of other additives on stability properties are discussed. Antioxidants, metal deactivators, and dispersants are used to improve the stability of middle distillate fuels; the range of benefits obtained and factors that affect performance are discussed. Different antioxidants are used in jet fuels to prevent formation of peroxides. Metal deactivators are used in all fuel types to prevent oxidation catalysis by dissolved metal salts. The effects of other additives including corrosion inhibitors, electrical conductivity additives, and cetane improver are considered.
A study of atherosclerosis regression in Macaca mulatta,: IV. Changes in coronary arteries from animals with atherosclerosis induced for 19 months and then regressed for 24 or 48 months at plasma cholesterol concentrations of 300 or 200 mg/dl

Abstract Young adult male rhesus monkeys ( Macaca mulatta ) were fed an atherogenic diet for 19 months. After 19 months of atherosclerosis induction, a baseline group was selected and necropsied to determine the extent and severity of coronary artery atherosclerosis before regression regimens were begun. The remaining animals were fed diets that varied in cholesterol concentration in order to maintain plasma cholesterol concentrations of either about 200 or 300 mg/dl for either 24 or 48 months. The changes in the coronary arteries of these animals were studied by comparing them to the baseline group. During the course of the experiment the lumen areas of the coronary arteries of the animals of both groups increased. Using morphometric techniques to determine the changes in sizes of the artery and changes in intimal areas, we were able to determine the amount of increase in lumen area that was due to growth of the coronary arteries and that due to change in intimal lesions. Among the animals maintained at about 300 mg/dl plasma cholesterol concentration, there was little or no increase in lumen areas that could be accounted for by regression of intimal plaque. In contrast, among the animals maintained at about 200 mg/dl plasma cholesterol concentration, a considerable proportion of the increases in lumen areas was due to regression of intimal plaques. The contribution of plaque regression to increases in lumen areas was dependent both on the size of plaques and time.
Evidence for the presence of a phosphatidylinositol anchor on the lipoarabinomannan and lipomannan of Mycobacterium tuberculosis.

The recent availability (Hunter, S.W., Gaylord, H., and Brennan, P.J. (1986) J. Biol. Chem. 261, 12345-12351) of the well known arabinomannan of Mycobacterium leprae and Mycobacterium tuberculosis as the pure native lipoarabinomannan has resulted in its implication in key aspects of the immunopathogenesis of leprosy and tuberculosis. We had indicated that the lipid moiety of lipoarabinomannan is probably based on a diacylglycerol unit in that glycerol and the two fatty acids, hexadecanoate and 10-methyloctadecanoate, were identified. In addition, lipoarabinomannan was also shown to contain myo-inositol 1-phosphate. Evidence is now presented, based on selective radiolabeling and analysis of various cleavage fragments, that the inositol phosphate exists as both an alkalilable phosphodiester and as part of a phosphatidylinositol "membrane anchor." The mannan of M. tuberculosis was also isolated as the native lipomannan. It also apparently contains a phosphatidylinositol unit but is devoid of the alkali-labile inositol phosphate residues. These lipopolysaccharides are apparently multiglycosylated versions of the well known myocobacterial mannosyl phosphatidylinositols and are prokaryotic versions of the growing list of phosphatidylinositol-anchored macromolecules. Immunogold labeling demonstrates that lipoarabinomannan is a true antigenic capsular or extracellular product of M. tuberculosis. The presence of a phosphatidylinositol residue on lipoarabinomannan may explain its interaction with macrophage membranes and role in mycobacterial pathogenesis.
Ecosystem health. IV. The National Animal Poison Information Network database as a tool for ecological risk assessment.

Abstract Toxicology is a unique discipline in human and veterinary medicine because there are orders of magnitude more toxicants available to man and animals than all known pathogenic microorganisms and parasites. The study of toxicologic responses of ecosystems to contaminants, ecoepidemiology, are concerned with identifying chemically induced causes and determining effects on and links among populations, communities, and ecosystems. Necessary activities implied by the term “epizootiologic ecotoxicology” are the systematic compilation and analysis of “health” data for ecosystem components. This concept paper describes the value and limitations of adapting methods used by the National Animal Poison Information Network (NAPINet) for epizootiologic ecotoxicology studies. It is concluded that NAPINet methodology, as part of an innovative use of population statistics and clinical measurements, could eventually be adapted into a valuable component of a standardized approach to epizootiologic ecotoxicology.
Engaging Stakeholders: The First Step to Increasing Digital Inclusion Abstract

This paper is intended to help local leadership striving to create cohesive 21 st century communities learn from the digital inclusion stakeholder engagement experiences of Rhode Island. Broadband Rhode Island’s (BBRI’s) public policy engagement process carefully engaged stakeholders from a variety of sectors, kept them engaged through a facilitated and well-planned process and is now implementing recommendations defined during the process.
The Complex Locus R in Mormoniella Vitripennis (Walker)

Publisher Summary This chapter focuses on the complex locus R in Mormoniella vitripennis (Walker). The Mormoniella vitripennis and Nasonia vitripennis (Walker) are two long names given to a 2-mm short wasp parasitic on the pupae of blowflies and other large species of muscoid Diptera. The sexes are readily separated, both as pupae and as adults, and large numbers of virgin females can be obtained by breaking open the puparial shells of infected hosts arid sexing the wasp pupae. Exposure of females to X-rays gave the first mutants, eye colors oyster and scarlet, and the exceptional genetical behavior of these was disclosed at once. The R-locus genes were selected from a large number that have been obtained by irradiation. This list includes two with semilethals, two with male steriles, two with near steriles, and ten with female steriles. Nine alleles were identified at the sex locus and no exception has been found to make it necessary to modify the original concept. Sex in a wasp is determined by the balance of two agents that have a short diffusion distance and that each must be produced by a different allele at one genetic locus.
How We Approach a Patient With Symptoms of Leukostasis Requiring Emergent Leukocytapheresis

Hyperleukocytosis can induce leukostasis, which can lead to vascular obstructions (usually in the lungs and central nervous system), tumor lysis syndrome, and disseminated intravascular coagulation. Although it has not been conclusively shown to improve long-term outcome, leukocytapheresis may be used as part of the management of hyperleukocytosis with or without leukostasis to rapidly reduce the white blood cell (WBC) burden. Since leukocytapheresis only temporarily decreases the WBC count, early initiation of more definite therapy, such as hydroxyurea and/or chemotherapy, is essential. In this article, clinical assessment of the patient's clinical status to determine the need for leukocytapheresis as well as a general guideline for management of the technical aspects and complications of the procedure are discussed.