cssi/SciSciGPT-SciSciNet huggingface dataset:
Synthesis and characterization of Cds and Cdse quantum dots by UV-VIS spectroscopy

The results of the experimental investigations of the synthesis and characterization of Cds and CdSe quantum dots is presented. In this work cadmium sulphide (CdS) and cadmium selenide(CdSe) quantum dots are synthesized successfully by adopting the hot injection/solvo thermal chemical synthesis method using octdecane as a non-coordinating high boiling point organic solvent in place of trioctyphosphine (Top) which posed environmental hazard. A sudden injection of room temperature sulphur and selenium solution into the hot cadmium solution produce seed crystals which grow quickly and they are monodispersed. Samples are withdrawn from the hot solution and quench at room temperature to produce a series of increasing quantum dots size. Subsequent characterization studies were carried out on the synthesized Cds and CdSe QDs using Uv-vis spectroscopy machine and irradiation with UV-light. The absorption spectra exhibit a strong blue-shift with decreasing size of QDs size, which is attributed to the quantum size effect (QSE). The sizes and band gaps of the Cds and CdSe were calculated, from the outcome of the calculation, it was deduced that the band gap energies varies from larger value to smaller values due to depletion of the band gap as a result of increased temperature. The results of this research are likely to be useful toward the understanding formation mechanism of CdS and CdSe.
Preparation of Multilayer Biodegradable Nanofibers by Triaxial Electrospinning

A biodegradable, multilayer nanofiber structure has been successfully developed by using a self-designed and fabricated triaxial electrospinning system using gelatin as the sheath and core layers and poly(e-caprolactone) (PCL) as the middle layer. The triaxial structure was investigated by confocal fluorescence microscopy (CFM) and focused ion beam and field-emission scanning electron microscopy (FIB-FESEM). The ability to fabricate the multilayered nanofibers efficiently with different biodegradable polymers will enable this triaxial electrospinning technique to have wider applications in biotechnology.
A Computational Design Framework for Flapping Micro Air Vehicles

The authors have embarked on the development of a Computational Design Framework as the means to synthesize and optimize highly integrated Micro Air Vehicle designs with flapping wings. This paper describes both the computational physics and the framework requirements that contribute to the overall design. Computational physics address inherently non-linear flapping aerodynamics and non-linear structures. Mathematical models of symbiotic non-linear behavior will feed design optimization in ways that bring out new and beneficial aeroelastic interactions. A preliminary design was initiated with simplified physics in order to begin design connectivity within the design framework. The framework builds on earlier reported developments with software classes (objects) that facilitate coordinated graphical animation using either a single or multiple windows.
Computer Simulations of Diffusion in Monolayers Physisorbed in Model Pores

Two types of model pore have been considered as sorbents of methane at 300 K: the first is a straight cylinder with atomically rough walls characteristic of an amorphous solid. Three cylinder radii plus the reference flat surface were taken for study. The second is a parallel-walled slit pore made up of graphite basal planes that had been modified by the insertion of sulfide atoms. Here, two values of sulfur loading were taken together with the reference pure graphite pore. Two values of the wall spacing were assumed for each sulfur loading. Thermodynamic and structural properties are presented elsewhere; here, the dependence of diffusion constants as a function of the monolayer density is presented for methane in the various model pores. It is shown that these diffusivities depend primarily on the methane-methane collisions in the monolayer films. There is a slight dependence upon the nature of the solid surface which is interpreted in terms of the hindrances produced by soft obstacles to molecular motion parallel to the surfaces.
Study of Associated Risk Factors Leading to Complication in Diabetic Foot Ulcer

Introduction- A diabetic foot ulcer is a poorly healing ulcer, caused by a combination of diabetes induced foot neuropathy, and diabetes induced vascular disease. Diabetic foot-related problems occur frequently and may have serious consequences. Amputations at different anatomical levels are the most serious of them. Methods and study design- A cross sectional study was carried out in patients presenting with diabetic foot, attending the surgical OPD and casual ty of Dr. BRAM Hospital, Raipur (C.G.) and admitted consecutively to surgical wards were included. Study was done in these patients from, August 2014 to September 2015. Data were collected including particulars of the patient, detailed history and examination. Wound is graded according to Wagner's classification system. 96 Cases were selected according to mentioned inclusion and exclusion criteria and on the basis of the simple random sampling technique. Result- diabetic foot complications were multifactorial.most common risk factors leading to diabetic foot complications was diabetes induced Ischemia of small and large blood vessels, (21.87%), followed by Diabetic neuropathy (16.66%), Poor glycemic control (15.62), Structural Deformities (14.58%), Cigarette smoking(11.45%),Non- compliance(8.33%), Hypertension(5.20%). Conclusion- The finding of this study is quite promising & shows associated various risk factors leading to complication in diabetic foot ulcers. We also know that patients with diabetes who undergo amputations are subsequently more likely to die & suffer further amputation. It also provides a useful database for starting a preventive foot care program & separate wound clinic for reduction in diabetic foot related morbidity &, mortality.
Perceptual significance hierarchy: a computer vision theory for color separation

A Perceptual Significance Hierarchy (PSH) for line art images is developed which represents the relative perceptual significance of each image component. This is possible through the use of a set of image-features which are used by the human visual system. The PSH and related rho-space computer vIsion algorithms can be used to automate the fake color separation process used by the printing industry. This is accomplished by adding rudimentary visual processing capabilities to a computer graphics system.
Analysis of Damage and Plasticity for Large Deformation with Application in Simple Shear

A coupled theory of continuum damage mechanics and finite strain plasticity is formulated in the Eulerian reference system. A linear transformation is shown to exist between the effective deviatoric Cauchy stress tensor and the total Cauchy stress tensor. In addition, an effective elasto-plastic stiffness tensor is derived that includes the effects of damage. The problem of finite simple shear is investigated. It is noticed that the resulting differential equations are solved numerically using a Runge-Kutta-Verner fifth order and sixth order method. The results for the stress, backstress and damage variables are compared with a previous damage theory by the authors, as well as with an undamaged plasticity model.
The novel kinase inhibitor ponatinib is an effective anti-angiogenic agent against neuroblastoma

Background High-risk neuroblastoma has poor outcomes with high rates of relapse despite aggressive treatment, and novel therapies are needed to improve these outcomes. Ponatinib is a multi-tyrosine kinase inhibitor that targets many pathways implicated in neuroblastoma pathogenesis. We hypothesized that ponatinib would be effective against neuroblastoma in preclinical models. Methods We evaluated the effects of ponatinib on survival and migration of human neuroblastoma cells in vitro. Using orthotopic xenograft mouse models of human neuroblastoma, we analyzed tumors treated with ponatinib for growth, gross and histologic appearance, and vascularity. Results Ponatinib treatment of neuroblastoma cells resulted in decreased cell viability and migration in vitro. In mice with orthotopic xenograft neuroblastoma tumors, treatment with ponatinib resulted in decreased growth and vascularity. Conclusions Ponatinib reduces neuroblastoma cell viability in vitro and reduces tumor growth and vascularity in vivo. The antitumor effects of ponatinib suggest its potential as a novel therapeutic agent for neuroblastoma, and further preclinical testing is warranted.
Measuring it Performance: “Contingency” Variables and Value Modes

The magnitude of investment in and the results expected from Information Technology (IT) is burgeoning equally rapidly. The rise in expectations is, however, not accompanied by an enhanced sophistication in the methods used to assess the outcomes of IT employment. Putting IT to multiple uses demands that measures of performance also be flexible and multidimensional. The traditional approach to measuring performance as the ratio between input and output is inadequate in this context. Several studies have utilized some form of input/output production function in measuring the impact of IT on profitability and productivity. There is a great need for taking a comprehensive look at the purpose and strategy underlying IT management and performance (“success”) measurement. Several classifying frameworks have been proposed and our research builds on this body of work. We propose an IT Effectiveness Model that links factors such as the external Environment, Strategy, Structure, and Culture to the mode of IT Deploy...
The role of ERK5 signaling in colorectal cancer

The mitogen-activated protein kinase (MAPK) family includes ERK1/2, p38, JNK and ERK5. The role of MAPKs in colorectal cancer (CRC) is well-established, in particular ERK1/2. Abnormal activation of receptor tyrosine kinases or gain-of-function mutations in critical upstream transducers, including KRAS and BRAF, are responsible for MAPK-mediated tumor progression in CRC. Compared to ERK1/2, the role of ERK5 in CRC development has been underrated. Here we discuss recent evidence for the involvement of ERK5 signaling in the development and progression of CRC, as well as its putative role in resistance to targeted therapy.
Portal Vein Thrombosis in the Setting of Newly Diagnosed Cushing’s Syndrome:

The hallmark manifestations of Cushing's syndrome (CS) are well known, but hypercoagulability is perhaps least recognized. Patients with CS are at increased risk of both spontaneous and postoperative thromboembolism, with the significant majority of events occurring in the lower extremity and pulmonary venous circulations. We present a case of portal vein thrombosis (PVT) occurring in the setting of newly diagnosed CS due to a left adrenal adenoma. Factor VIII activity was approximately 2.5-fold elevated, a known mechanism by which hypercortisolemia predisposes to venous thrombosis. Acute abdominal pain and fever responded well to unfractionated heparin and parenteral antibiotics, and CS was eventually cured by left adrenalectomy. No thromboembolic events have occurred since surgery. PVT is uncommon and usually occurs as a complication of primary or secondary hepatobiliary malignancies and cirrhosis. To the best of our knowledge, this is just the second reported case of PVT due to CS and the first published in the English language literature.
Cortactin in invadopodia formation

Proc Amer Assoc Cancer Res, Volume 47, 2006 1821 Invadopodia are invasive foot processes used by cancer cells to degrade extracellular matrix and move through tissue barriers, that depend on src kinase signaling and branched actin assembly. Podosomes are analogous structures found in src kinase-transformed cells that are molecularly and functionally similar to invadopodia. We studied the role of cortactin, a prominent invadopodia component, actin assembly molecule and src kinase substrate in cancer cell invasion and invadopodia formation. We found that cortactin promotes cancer cell invasion, through a domain that includes the src kinase phosphorylation sites and SH3 domain. To address the role of cortactin specifically in src-kinase-induced invadopodia/podosome formation, we knocked down cortactin in src-kinase transformed mouse embryonic fibroblasts. We found that cortactin knockdown inhibited podosome ring formation and matrix degradation in a time-dependent manner. We hypothesize that enhanced invadopodia formation may account for the aggressive behavior of cancers with amplifications in the cortactin/EMS1 gene.
Recombinant adeno-associated virus-mediated gene transfer into hematopoietic progenitor cells [published erratum appears in Blood 1995 Feb 1;85(3):862]

Recombinant adeno-associated viruses (rAAV) containing only the inverted terminal repeats (ITR) from the wild-type virus are capable of stable integration into the host cell genome, and expression of inserted genes in cultured cells. We have now defined the ability of rAAV to introduce genes into primary hematopoietic progenitors. A vector was constructed containing the coding sequences for beta- galactosidase (beta-gal), including a nuclear localization signal, under the control of a strong viral promotor. Infectious vector particles were prepared by cotransfection of the vector plasmid with a second plasmid that contained the coding sequences for AAV proteins into adenovirus-infected human embryonic kidney cells. These vector preparations transferred and expressed the beta-gal gene in human K562 erythroleukemia and Detroit 6 cells. Positive immunoselection yielded a population of enriched CD34+ cells that were transduced with the rAAV beta-gal vector. Nuclear localized enzyme expression was documented in 60% to 70% of infected cells. Progenitor-derived colonies that developed after 2 weeks in clonogenic cultures were shown to have viral- associated DNA at an estimated copy number of 1 to 2 per cell using a semiquantitative polymerase chain reaction (PCR) method. Integration of AAV into hematopoietic progenitors was documented using wild-type virus, as its genome may integrate at a preferred site on chromosome 19. Our data suggest that rAAV will transfer and express genes in primitive hematopoietic progenitors with high frequency, and support the development of this vector system for therapeutic gene transfer.
Guidelines for the management of thoracic aortic disease in 2017

This review provides a general overview of the consensus statement from the 2010 more recent updates AHA/ACC Guidelines for the Diagnosis and Management of Patients with Thoracic Aortic Disease, and highlights current practice patterns. The suggestions herein are intended to facilitate clinical decision making in the management of thoracic aortic disease. The main intent of this report is to highlight screening, surveillance, initial and definitive management of thoracic aortic disease, and special populations that should be considered.
Minireivew of leptoquark Searches

Publisher Summary This chapter reviews the direct and indirect leptoquark (LQ) searches at colliders. LQs are hypothetical bosons that couple to a lepton and a quark via a Yukawa coupling (denoted λ). These are color triplets that would be a pair produced in either q q ¯ or gg interactions at p p ¯ or pp colliders. At the HERA electron–proton collider, first-generation leptoquarks can be singly produced via the fusion of the beam electron with valence quarks in the proton. A LQ signal is distinguished from the DIS background by the angular distribution of the final-state leptons. Three sorts of leptoquark searches have been performed at LEP. Leptoquarks with M L Q ≪ s / 2 would be pair produced via electroweak coupling. Single LQ production can occur via the interaction of an electron with a radiated photon, which resolves into q q ¯ . For first generation leptoquarks, the Tevatron experiments have set limits on scalars (coupling to eq) of MLQ > 242GeV and corresponding vector LQ limits in the range from 233 to 345GeV, depending on model assumptions. The HERA experiments have set lower mass limits in the range of ∼ 250 to 280GeV for λ = 0.1. In addition, searches at the Tevatron and LEP have constrained LQs coupling to the leptons and quarks of the second and third generations.
Tensor Products, Entanglement, and Addition of Spin

If one has two independent quantum systems, with state spaces \(\mathcal H_1\) and \(\mathcal H_2\), the combined quantum system has a description that exploits the mathematical notion of a “tensor product,” with the combined state space the tensor product \(\mathcal H_1 \otimes \mathcal H_2\).
Applications of the Hardy-Weinberg Law

Can any real population satisfy the stringent conditions outlined in Lecture 2, under which our theoretical population reached Hardy- Weinberg equilibrium? Probably not; but many real populations have been shown to produce genotypes, with respect to some traits at least, in a ratio not significantly different from p2: 2pq: q2.
The Dialectical Self: Immunology’s Contribution

What is the Self? Clearly the concept is a construction dependent on the organisms studied and the scientific discipline invoked for its criterion. From an anthropocentric vantage, the immunological manifestation of organismic Self is highly evocative. We are impressed with the extraordinary ability of the host to differentiate self elements from those invaders deemed dangerous; Lactobacillis in yogurt is fine, Staphalococcus is not; we “eat” one and attempt to destroy the other. Immunology, at least, for human biology, has become a crucial element of erecting the Self. But we are dissatisfied with the current interpretation of its nature.
Response Times to User Activities in Interactive Man/Machine Computer Systems:

Response times (response delays) in interactive computer systems can greatly effect user performance and system productivity. This document summarizes the literature on user response time needs in interactive computer systems, and presents a set of guidelines for specifying response times that meet those needs. During the literature survey, it became evident that much more supporting data is required in order to have guidelines that cover most conditions under which people use a computer, and in order to provide a solid foundation of data taken from real world user interaction with computer systems. The information presented in this document should be viewed as a starting point for further work on defining response time needs for interactive computer system users.
An interesting case of bishop-koop stoma prolapse.

A 4-month-old male baby presented with enterostomy prolapse. Past medical history revealed two operations elsewhere during third week of life. The first operation was performed for pneumoperitoneum due to necrotizing enterocolitis (NEC) of distal jejunum. The involved portion of small intestine was resected and a primary end-to-end jejuno-ileal anastomosis performed. The patient had to be re-explored due to anastomotic disruption and then an end-to-side jejuno-ileal anastomosis with Bishop-Koop ileostomy fashioned [Image 1]. The patient remained well for three months and passed stool per rectally and occasionally from stoma.
Quantized Vortices in Molecular Scattering

Since the period 1925–35 is known as the Golden Age of Quantum Chemistry the 1970’s should be called the Platinum Age. Thanks to the miracle of electronic technology, we can now perform all sorts of sophisticated experiments with precisions of one part in 107 being common; and, thanks to the same electronic technology, the theoretical chemists can solve all sorts of problems by making use of available subroutines and giant computers. The changes in chemical physics are occurring so rapidly it is hard to believe that only ten or twenty years ago, we believed that if only we could solve the Schrodinger equation with the electrostatic Hamiltonian, we would know the answers to most chemical problems. Most theoretical chemists regarded the relativistic corrections which lead to fine and hyperfine structure as being important in spectroscopy but not in chemistry. At the First Boulder Symposium, Coulson distinguished between Class A quantum chemistry which used a priori theory to treat small molecules, and Class B quantum chemistry which used semi-empiricism to understand the large molecules. Coulson speculated that it would be a very long time before a priori methods could be used to consider the complexities of large molecules. Thus, we have come a long way in a very short time. The present generation of quantum chemists must be topflite theoretical physicists well versed in all manner of sophisticated techniques.
WEAK INTERACTION OF LEPTONS WITH FEW-NUCLEON SYSTEMS - MESON AND NUCLEON-ISOBAR EFFECTS

Publisher Summary This chapter focuses on the weak interaction of Leptons with few nucleon systems, and discusses the effects of meson and nucleon-isobar. An atomic nucleus with mass number (A) and charge number (Z) can be regarded as a composite system. This system consists of Z protons and A–Z neutrons as basic constituents in mutual strong coupling, with the weak properties of the intranuclear protons and neutrons identical with the weak properties of isolated protons and neutrons, and with the effective nuclear weak-current operator a sum of contributions (with appropriate relative phases) from the individual intranuclear protons and neutrons. The meson terms can be introduced as a correction to the nucleons-only impulse-approximation (NOIA) effective nuclear weak-current operator arising from the meson-exchange processes. The chapter also discusses the presence of nuclear–physics motivation in any systematic search for the effects of exotic hadron weak currents in nuclear beta decay, muon capture, and neutrino interactions because any evidence for the existence of such exotic currents in a nuclear context is an evidence for the intranuclear presence of mesons and nucleon-isobars.
A New Woody Plant Which Fixes Nitrogen: Chamaebatia Foliolosa (Rosaceae)

Root nodules, and presumably nitrogen fixation, occur in at least 18 genera of nine angiosperm families outside of the Leguminosae (Bond, 1976; Akkermans and Houwers, 1979; Righetti and Munns, 1980). Nearly all the nodulated non-legumes are woody shrubs or trees. Except for one genus in the Ulmaceae (Akkermans et al., 1978), which is nodulated by Rhizobium (Trinick, 1973), all the other such species whose endophytes have been investigated are thought to be nodulated by actinomycetes (Akkermans and Houwers, 1979).
Horton: Online Query Execution Engine for Large Distributed Graphs (Demo Track)

Large graphs are used in many applications, such as social networking. The management of these graphs poses new challenges because such graphs are too large to fit on a single server. Current distributed techniques such as map-reduce and Pregel are not well-suited for processing interactive adhoc queries against large graphs. In this paper we demonstrate Horton, a distributed interactive query execution engine for large graphs. Horton defines a query language that allows expressing regular language reachability queries and provides a query execution engine with a query optimizer that allows interactive execution of queries on large distributed graphs in parallel. In the demo, we show the functionality of Horton managing a large graph for a social networking application called Codebook, in which a graph models data on software components, developers, development artifacts (such as bug reports), and their interactions in large software projects.
An Active Android Application Repacking Detection Approach

Repackaging applications as the main carrier of Android malware have caused huge losses to users. In addition, the third-party application market that Android applications rely on is characterized by missing audits and lax supervision, which further encourages the distribution of repackaged applications. Most of the traditional repackaging detection approaches need to rely on a third-party detection platform to passively determine whether or not the Android application is repackaged, which has a high false negative rate. In order to solve the problem, this paper proposes an active detection approach for Android code repacking. The approach embeds code watermarking with the detection code into the appropriate conditional branch code block by means of dynamic loading to achieve the hidden purpose. Then, the active detection approach compares the consistency of the runtime application signature and the original code watermarking signature to realize the code repackaging recognition. Finally, this work takes eight different types of Android applications from Github on three different mobile phones to verify the validity of the approach. Experimental results show that an Android application containing a self-detecting code watermarking can effectively perform repackaging detection without relying on third parties.
The Principle of Double Effect

This chapter is an evaluation of the principle of double effect. The principle of double effect is a principle congenial to the just war theory and is appealed to by just war theorists. It is a principle that under certain circumstances can relieve perpetrators of war actions that inflict suffering on innocents (or have other harmful or evil effects) from responsibility for those effects. The principle asserts that an action, such as a war action, done with an intention to bring about a good effect is permissible though it has other harmful effects, provided that those harmful effects are not intended, even if they are foreseen. This principle, it will be argued, is deeply flawed, and if accepted as valid in a wartime application, it can be used to justify virtually any horrendous war action.
Political Mobilization and Empowerment in the Rural Alabama Black Belt: A Comparative Analysis of Sumter and Greene Counties

This study examines the process of political change in the rural Alabama Black Belt counties of Greene and Sumter, located in the southwestern region of the state. Focusing on the period from the early 1960s through the mid-1980s, this study compares the processes of political mobilization and empowerment in these counties to account for divergent rates of political change. The nature and pattern of leadership, organizations, and the strategies and tactics employed to achieve mobilization and empowerment are discussed. Moreover, the utility of Aldon Morris’ indigenous perspective is assessed for understanding the dynamics of mobilization and empowerment in the rural Black Belt. The results reveal that leadership monopolization in the social change process at the local level has its benefits as indicated by the relatively rapid pace with which black majority rule was instituted in Greene County. In contrast, in Sumter County where leadership monopolization was far less pronounced, the empowerment process was more arduous and delayed. However, the Federation of Southern Cooperatives, established in 1967, evolved into a local movement center proxy, thereby leveling the playing field to help propel to power by 1986 a black majority to the Sumter County government.
Vacancies for controlling the behavior of microstructured three-dimensional mechanical metamaterials:

Mechanical metamaterials are designed to exhibit enhanced properties not found in natural materials or to bolster the properties of existing materials. The theoretical foundations for tuning the me...
Western Sahara Conflict

The paper revolves around the study of the Western Sahara Conflict with special attention to its historical background, the actors involved, the current situation and the possible outcomes (if any) in the future.
A Direct Test of the

This paper uses the 2011 Phoenix Area Social Survey to evaluate the plausibility of the assumptions made with pure characteristics or vertical sorting models to rationalize incomplete stratification of households across local communities by income. The analysis with a well-recognized index of environmental attitudes, the New Ecological Paradigm (NEP), confirms the correlations in equilibrium outcomes implied by these models. As a result, it supports the role of differences in the tastes for public goods as an explanation for the sorting outcomes.
PATHVIEW WEB: USER FRIENDLY PATHWAY VISUALIZATION AND DATA INTEGRATION

Background Pathway analysis is widely used in omics studies. Pathway-based data integration and visualization is a critical component of the analysis. To address this need, we recently developed a novel R package called Pathview. Pathview maps, integrates and renders a large variety of biological data onto molecular pathway graphs. Pathview quickly became a leading tool in pathway visualization, and has been widely adopted by tens of thousands of scientists and dozens of dependent applications worldwide. Methods Here we developed the Pathview Web server, as to make pathway visualization and data integration accessible to all scientists, including those without the special computing skills or resources. Pathview Web features an intuitive graphical web interface and a user centered design. We also provide a comprehensive online help system and multiple quick-start example analyses. Even with no special computing training and resources, users may still accomplish pathway based data visualization and integration independently. Results The server not only expands the core functions of Pathview, but also provides many useful features not available in the offline R package: 1) The results graphs are interactive and hyperlinked to abundant external annotation data online; 2) The server provides the latest, most complete and accurate pathway definitions and graphs by regular synchronization with KEGG source databases; 3) Users can review, replicate and share their analyses easily with free registered user accounts, which enable collaborative research and reproducible science; 4) Useful user engagement features allow users make comments and suggestions, or ask for help in designated pages. Importantly, the server presents a comprehensive workflow for both regular and integrated pathway analysis of multiple omics data. In addition, the server also provides a RESTful API for programmatic access and conveniently integration in third-party software or workflows. Discussion Pathview Web is openly and freely accessible at https://pathview.uncc.edu/ .
Effect of Physical Activity Coaching on Acute Care and Survival Among Patients With Chronic Obstructive Pulmonary Disease: A Pragmatic Randomized Clinical Trial

Importance While observational studies show that physical inactivity is associated with worse outcomes in chronic obstructive pulmonary disease (COPD), there are no population-based trials to date testing the effectiveness of physical activity (PA) interventions to reduce acute care use or improve survival. Objective To evaluate the long-term effectiveness of a community-based PA coaching intervention in patients with COPD. Design, Setting, and Participants Pragmatic randomized clinical trial with preconsent randomization to the 12-month Walk On! (WO) intervention or standard care (SC). Enrollment occurred from July 1, 2015, to July 31, 2017; follow-up ended in July 2018. The setting was Kaiser Permanente Southern California sites. Participants were patients 40 years or older who had any COPD-related acute care use in the previous 12 months; only patients assigned to WO were approached for consent to participate in intervention activities. Interventions The WO intervention included collaborative monitoring of PA step counts, semiautomated step goal recommendations, individualized reinforcement, and peer/family support. Standard COPD care could include referrals to pulmonary rehabilitation. Main Outcomes and Measures The primary outcome was a composite binary measure of all-cause hospitalizations, observation stays, emergency department visits, and death using adjusted logistic regression in the 12 months after randomization. Secondary outcomes included self-reported PA, COPD-related acute care use, symptoms, quality of life, and cardiometabolic markers. Results All 2707 eligible patients (baseline mean [SD] age, 72 [10] years; 53.7% female; 74.3% of white race/ethnicity; and baseline mean [SD] percent forced expiratory volume in the first second of expiration predicted, 61.0 [22.5]) were randomly assigned to WO (n = 1358) or SC (n = 1349). The intent-to-treat analysis showed no differences between WO and SC on the primary all-cause composite outcome (odds ratio [OR], 1.09; 95% CI, 0.92-1.28;P = .33) or in the individual outcomes. Prespecified, as-treated analyses compared outcomes between all SC and 321 WO patients who participated in any intervention activities (23.6% [321 of 1358] uptake). The as-treated, propensity score–weighted model showed nonsignificant positive estimates in favor of WO participants compared with SC on all-cause hospitalizations (OR, 0.84; 95% CI, 0.65-1.10;P = .21) and death (OR, 0.62; 95% CI, 0.35-1.11;P = .11). More WO participants reported engaging in PA compared with SC (47.4% [152 of 321] vs 30.7% [414 of 1349];P Conclusions and Relevance Participation in a PA coaching program by patients with a history of COPD exacerbations was insufficient to effect improvements in acute care use or survival in the primary analysis. Trial Registration ClinicalTrials.gov identifier:NCT02478359
Evaluation of Dextrose Gel Administration to Infants with Asymptomatic Neonatal Hypoglycemia: A Single Center Experience

Purpose: We recently implemented a clinical practice guideline for asymptomatic neonatal hypoglycemia that includes use of dextrose gel. Following this change in practice, we sought to identify characteristics of infants at risk for needing two dextrose gels or intravenous fluids (IVF) containing dextrose. We also compared infants’ response to gel administration by feeding group. Methods: Any infant who received dextrose gel within the first 48 hours following birth over a 13 month period of time (January 2016-January 2017) at a large academic medical center was included in our evaluation. Participant characteristics were stratified by types of intervention received (received gel …
Development on purpose: Faith and human behavior in the social environment: by L. Hosack, P.O. Box 121, Botsford, CT 06404-0121, North American Association of Christians in Social Work, 2019, ISBN: 978-0-9897581-5-4

Lisa Hosack’s Development on Purpose: Faith and Human Behavior in the Social Environment provides the reader with a comprehensive overview of the theories traditionally encompassed in human behavio...
Separate but Equal? The Sorting of USMDs and Non-USMDs in Internal Medicine Residency Programs

The US internal medicine workforce relies on international and osteopathic medical graduates to fill gaps in residency. Little is known about the distribution and impact of IMGs, DOs, and USMDs concentrating in different types of IM programs. Determining the extent to which USMDs, DOs, and IMGs concentrate in different types of IM programs and comparing Board pass rates by program concentration. This survey study used data from the AMA’s FREIDA database for 476 non-military IM programs in 2017–2018, and 2016–2018 ABIM exam pass rates for 388 accredited programs. Outcomes were (1) program concentration based on percentage of residents who were USMDs, IMGs, and DOs in 2017–2018 and (2) 2016–2018 program ABIM pass rates as proxies for program quality. Key independent variables were hospital type (community-based, community-based university-affiliated, or university-based) when program concentration was the outcome, and program concentration when Board pass rates were the outcome. Twenty-five percent of programs were “USMD-dominated,” 17% were “DO-dominated,” 42% were “IMG dominated,” and 16% were “integrated.” The chances that a university hospital was USMD-dominated were 32 percentage points higher than that for a community hospital (AME = 0.32, baseline probability = 0.11, 95% CI, 0.17–0.46, P < .001). USMD-dominated programs also had significantly higher pass rates by 4.0 percentage points (AME = 0.04, baseline proportion = 0.90, 95% CI, 0.02–0.06, P < .001) than integrated programs, while DO-dominated programs had significantly lower pass rates (AME = − 0.1, baseline proportion = 0.90, 95% CI, − 0.15 to − 0.04, P < .001). USMDs and non-USMDs systematically cluster in certain types of residency programs and their training may not be equal, as measured by board pass rates.
Characteristics of Fecal Microbiota Transplantation Use in Inflammatory Bowel Disease Cohort.

Background There is a growing interest in the role of gut bacteria in a number of diseases and an emerging hypothesis that inflammatory bowel disease (IBD) is triggered by microbial dysbiosis in genetically susceptible individuals. Currently, fecal microbiota transplantation (FMT) is utilized for the treatment of Clostridium difficile colitis. Data on the efficacy of FMT for IBD are mixed, but patients are interested in its use for the treatment of IBD. We sought to describe the use of FMT (self or medical professional administered) in individuals with IBD using IBD Partners, an Internet-based cohort. Methods Patients enrolled in the IBD Partners cohort were offered the opportunity to complete an optional survey on the use of FMT between January 2017 to September 2018 (n = 5430). A cross-sectional analysis was performed within patients who completed the survey and did not have a pouch or ostomy. Patients' demographic characteristics, disease activity and phenotype, mode of FMT delivery, and patient-reported efficacy were compared. Results Among 3274 eligible patients, 51 (1.6%) responded that they had an FMT in the past. Of patients undergoing FMT, 22 patients had the FMT for C. difficile while 29 reported that the FMT was for another indication. Most patients receiving FMT for an indication other than C. difficile had ulcerative colitis/indeterminate colitis (25, 86.2%). Colonoscopy (68.2%) and nasogastric tube (18.2%) were the most common routes of administration for patients receiving FMT for C. difficile colitis. Self-administration (72.4%) and enemas (17.2%) were the most common routes of administration in patients receiving FMT for an alternate indication. Patients reporting FMT for an indication other than C. difficile were less likely to have a physician directing their FMT treatment (20.6%) as compared to patients receiving FMT for C. difficile (86.3%). Patient-reported efficacy was lower for FMT given for a non-C. difficile indication. Conclusions Patients undergoing FMT for an indication other than C. difficile infection were more likely to have ulcerative colitis, self-administer FMT, and were less likely to be receiving FMT under the guidance of a medical professional. FMT was not as effective for symptoms when given for a non-C. difficile indication. Patients should be counseled on potential harms and lack of proven benefit associated with FMT for IBD indications to try to discourage self-administered FMT without proper medical oversite.
Chapter 63 – Lipoprotein Complexes

: Free fatty acids (FFAs), triglycerides (TGs), phospholipids (PLs), cholesterol (CH), and cholesterol esters (CEs) are normally transported in blood in close association with protein. CMs and VLDL transport the greatest proportion of TG in blood, while LDL and HDL transport the greatest proportion of CH. Apo-B is the main integral apoprotein of CMs, VLDL and LDL, while Apo-C and Apo-E are peripheral apoproteins of HDL. HDL is also known as a1-lipoprotein. The clearance of lipoproteins from blood is facilitated by insulin-sensitive LPL, which is found on the capillary endothelium servicing adipocytes and other tissues. Lipoproteins do not normally cross the blood-brain-barrier, or the placental barrier. Lipoprotein complexes are not normally found in bile, or urine. FFAs are also known as non-esterified fatty acids (NEFAs). The transport of FFAs in blood is facilitated by albumin. FFAs are considered to be the most metabolically active lipids in blood. Abnormalities in lipoprotein metabolism generally occur at the site of their production, or the site of their destruction.
DOACs Versus VKAs in Older Adults Treated for Acute Venous Thromboembolism: Systematic Review and Meta-Analysis.

Background/objectves Four direct-acting oral anticoagulants (DOACs) are currently approved by the Food and Drug Administration for the treatment of venous thromboembolism (VTE). Limited efficacy and safety data are available for their use in older adults (aged ≥75 years). Methods Medline, Cochrane Central Register of Controlled Trials, Embase, EBSCO, Web of Science, and CINAHL databases were searched for trials comparing DOACs with vitamin K antagonists (VKAs) for the treatment of VTE in older adults from inception through January 1, 2020. Meta-analysis was performed to assess the combined endpoint of recurrent VTE and related deaths and bleeding events (composite of major and clinically relevant nonmajor bleeding). The Mantel-Haenszel relative risk (RR) random effects model was used to pool results across studies. Results Six randomized controlled trials at low risk of bias met criteria for inclusion with a total of 3,665 patients aged 75 years and older with follow-up of 24 weeks or longer. Data for bleeding events were not available for dabigatran. Overall, DOACs had an improved efficacy over VKAs (RR = .56; 95% confidence interval [CI] = .38-.82). There was no statistically significant difference in the safety outcomes (RR = .77; 95% CI = .56-1.05). No significant heterogeneity was observed for efficacy outcome, and only moderate heterogeneity was observed for safety outcome. Conclusion In older adults with VTE, DOACs appear to improve rates of recurrent VTE and VTE-related deaths compared with VKAs with similar bleeding outcomes.
Treatment of humerus surgical neck fracture with interlocking intramedullary nail versus locking plate

Objective To compare efficacy between the interlocking intramedullary nail and the locking plate in the treatment of humerus surgical neck fractures.Methods From January 2003 through June 2008,36 patients with humerus surgical neck fracture were randomized into an interlocking intramedullary nail group (21 cases ) and a locking plate group ( 15 cases).They were 11 males and 25 females,with an average age of 60.3 years (range,26 to 78 years).According to the Neer system,there were 6 cases of type Ⅱ,13 cases of type Ⅲ and 2 cases of type IV in the nail group,while there were 4 cases of type Ⅱ,8 cases of type Ⅲ and 3 cases of type IV in the plate group.The data of wound length,operative time,intra-operative blood loss,fracture healing time and functional recovery were recorded and analyzed statistically.Results The follow-up periods ranged from 6 to 24 months (average,15.3 months).There were significant differences between the 2groups( P ＜ 0.05 ) in wound length,operative time and intra-operative blood loss,but the average fracture healing time was not significantly different between the groups( P ＞ 0.05).The functional recovery was better in the intramedullary nail group than in the locking plate group but with no significance( P ＞ 0.05).Conclusion Although both theinterlocking intramedullary nail and the locking plate are similarly effective in the treatment of humerus surgical neck fractures,the former has an advantage in operative invasion and manipulative simplicity. Key words: Hurneral fractures, proximal; Fracture fixation, internal; Treatment outcome
Student Personnel Work: Role Conflict and Campus Power.

Campus events in the 1960s have revealed student personnel workers in two roles, both of which are inconsistent with the image the profession has attempted to project. Either personnel people have been notably inconspicuous in the midst of transpiring events, or they have been (with other administrators) targets of vehement attack. This observation raises critical concerns about the roles and functions of college student personnel workers as viewed by administrative superiors, by students, and by themselves.
Six species of Grandidierella collected from the Ryukyu Archipelago in Japan, with descriptions of four new species (Crustacea: Amphipoda: Aoridae).

Six species of the amphipod genus Grandidierella Coutiere, 1904 were collected from coastal areas of the Ryukyu Archipelago in Japan. Four species are new to science and the other two are new to Japan. Grandidierella contigua sp. nov. has a characteristic male gnathopod 1 with three teeth on the carpus, the proximal tooth of which is very small and contiguous with the large middle tooth. Grandidierella gilesi Chilton, 1921 is characterized by the densely setose gnathopods and the divergent merus of the gnathopod 2 in both sexes. Grandidierella halophila Wongkamhaeng, Pholpunthin & Azman, 2012 possesses a long posteromedial projection on the male coxa 2. Grandidierella japonicoides sp. nov. closely resembles G. japonica Stephensen, 1938 in having stridulating ridges on the male gnathopod 1 carpus, but the former can be distinguished from the latter in the presence of a posteromedial projection on the male coxa 2 and the shapes of the gnathopod 1 carpus in both sexes. Grandidierella nana sp. nov. is a small species and has a wide and short carpus in the male gnathopod 1. Grandidierella pseudosakaensis sp. nov. is similar to G. osakaensis Ariyama, 1996; however, the former is different from the latter in the absence of a posterodistal projection on the male gnathopod 1 ischium and the growth process of the male gnathopods. A key to Grandidierella species in the Ryukyu Archipelago is provided.
Using the 4Ms framework to teach geriatric competencies in a community clinical experience

Background As the population of older adults in the US steadily increases and becomes more diverse, there is an urgent need to integrate geriatric competencies into baccalaureate nursing education. Purpose To integrate the Institute for Healthcare Improvement 4 Ms Framework into an existing baccalaureate nursing community clinical experience to build geriatric and interprofessional competencies and promote positive health outcomes. Methods As part of the Geriatric Workforce Enhancement Program, 15 students worked with bilingual social workers and community health workers in an affordable housing urban highrise, assessed building residents and implemented personalized plans of care using the 4Ms framework (what matters to the individual, medications, mentation, and mobility). Results Students demonstrated competence conducting cognition and depression screening, medication review, and functional and fall risk assessments. Student self-rated achievement of learning objectives ranged from 4.3 to 4.8 (1-5 scale). A retrospective pretest-posttest survey suggested learning about the importance of interprofessional teamwork, and integration of person-centered values when providing care to older adults in the community. Students reflected on barriers to health for older adults in low socioeconomic states and the importance of improving care across the continuum. Conclusion The 4Ms framework provided a valuable construct to guide the community experience and teach geriatric evidence-based practice to nursing students.