cssi/SciSciGPT-SciSciNet huggingface dataset:
482 INHIBITION OF MARROW STROMAL CELL OSTEOGENESIS BY POLYMETHYLMETHACRYLATE WEAR PARTICLES AND SOLUBLE FACTORS RELEASED FROM POLYMETHYLMETHACRYLATE PARTICLE-ACTIVATED MACROPHAGES.

Purpose Implant loosening of total joint arthroplasty may involve reduced bone formation resulting from the effects of prosthetic wear debris on osteoblast precursors. The inhibition of osteoblastic differentiation by wear debris may occur via a direct effect of wear particles on osteoblast progenitors or via an indirect effect of inhibitory cytokines released from particle-activated inflammatory cells. This study determined whether the direct exposure of marrow stromal cells to polymethylmethacrylate (PMMA) cement particles inhibits the ability of these cells to differentiate into osteoblasts and whether macrophages exposed to PMMA particles produce soluble factors that can indirectly inhibit osteogenesis. Methods Osteogenesis was induced by growing murine marrow stromal cells (MSCs) in osteogenic medium containing 10−7 M dexamethasone, 50 μg/mL ascorbic acid, and 10 mM β-glycerophosphate for 15 days. Throughout their 15-day culture period in osteogenic medium, MSCs were either directly challenged with PMMA particles (0.30% v/v) or incubated in conditioned medium from Raw264.7 macrophage cultures that had been pretreated with PMMA particles (0.30% v/v) for 24 hours. To determine whether the effects of PMMA particles on MSC osteogenesis were reversible, particles were removed from MSC cultures after 1, 3, and 5 days of particle treatment, and cell growth in osteogenic medium was continued in the absence of particles for 15 more days. MSC cultures were assessed for the levels of cell proliferation, alkaline phosphatase expression, and bone mineralization at the end of the 15-day osteogenic period. Results MSCs treated with PMMA particles throughout the 15-day culture period showed a 90 to 95% reduction in the levels of proliferation, alkaline phosphatase expression, and mineralization. MSCs treated with PMMA for only 5 days also showed a 90 to 95% reduction in these outcome parameters, whereas MSCs treated for ≤ 3 days showed a significantly diminished inhibitory response. MSCs incubated in conditioned medium from particle-treated macrophages showed a significant 53% reduction in mineralized nodules. Conclusions This study has demonstrated that the direct exposure of MSCs to PMMA particles causes complete, irreversible suppression of osteogenesis. Macrophages exposed to PMMA particles also release soluble factors that can inhibit mineralization. The inhibition of bone growth during implant loosening is therefore due to the effects of wear particles and macrophage-released cytokines on osteoblast progenitors.
Factors associated with the receipt of antimicrobials among chronic hemodialysis patients

Background Antimicrobial use is common among patients receiving chronic hemodialysis (CHD) and may represent an important antimicrobial stewardship opportunity. The objective of this study is to characterize CHD patients at increased risk of receiving antimicrobials, including not indicated antimicrobials. Methods We conducted a prospective cohort study over a 12-month period among patients receiving CHD in 2 outpatient dialysis units. Each parenteral antimicrobial dose administered was characterized as indicated or not indicated based on national guidelines. Patient factors associated with receipt of antimicrobials and receipt of ≥1 inappropriate antimicrobial dose were analyzed. Results A total of 89 of 278 CHD patients (32%) received ≥1 antimicrobial doses and 52 (58%) received ≥1 inappropriately indicated dose. Patients with tunneled catheter access, a history of colonization or infection with a multidrug-resistant organism, and receiving CHD sessions during daytime shifts were more likely to receive antimicrobials (odds ratio [OR], 5.16; 95% confidence interval [CI], 2.72-9.80; OR, 5.43; 95% CI, 1.84-16.06; OR, 4.59; 95% CI, 1.20-17.52, respectively). Patients with tunneled catheter access, receiving CHD at dialysis unit B, and with a longer duration of CHD prior to enrollment were at higher risk of receiving an inappropriately indicated antimicrobial dose (incidence rate ratio, 2.23; 95% CI, 1.16-4.29; incidence rate ratio, 2.67; 95% CI, 1.34-5.35; incidence rate ratio, 1.11; 95% CI, 1.01-1.23, respectively). Conclusions This study of all types of antimicrobials administered in 2 outpatient dialysis units identified several important factors to consider when developing antimicrobial stewardship programs in this health care setting.
Series injection enabled full ZVS light load operation of a 15kV SiC IGBT based dual active half bridge converter

The 15kV SiC IGBT has second higher dv/dt turn-off slope above the punch-through level resulting in EMI. Increasing gate-resistance also slows the first dv/dt causing increased switching loss. A snubber capacitor assisted turn-off solves these issues for a high power dual active bridge (DAB) converter based on this device, but the light load turn-on ZVS becomes hard to achieve. This paper proposes a series injection enabled triangular current shaping at the light load turn-off instant in the DAB to create enough current for smooth free-wheeling transition of device voltage during the dead-time period for ZVS turn-on. The proposed technique is validated through simulations followed by experiments on a medium voltage DAB hardware implementation of this technique.
Imaging and Quantitative Data Acquisition of Thinly and Thickly Sliced Biological Tissues with Scanning Acoustic Microscopy

This article describes some techniques for using a mechanical scanning acoustic reflection microscope (SAM) to obtain unique information about thinly and thickly sliced biomedical tissues. In this study, first, the SAM images of specimens thickly sectioned from the tissue were analyzed. Optical and scanning acoustic microscopies were used to evaluate tissues of human small intestine and esophagus. For preparing thin specimens, the tissue was embedded in paraffin, and sectioned at 5~ 10µm by the microtome. For optical microscopy, the tissue was stained with hematoxylin and eosin, and affixed onto glass substrates. For scanning acoustic microscopy, two types of specimens were prepared: thinly sectioned specimens affixed on the glass substrate, wherein the specimens were deparaffinized in xylene, but not stained, and thickly sectioned specimens. Images of the thick specimens obtained with frequency at 200 MHz revealed cellular structures. The morphology was very similar to that seen in the thinly sectioned specimens with optical and scanning acoustic microscopy. In addition, scanning electron microscopy was used to compare the images of biological tissue. An acoustic lens with frequency at 200 MHz permitted the imaging of surface and/or subsurface of microstructures in the thick sections of small intestine and esophagus. Second, a technique to measure velocity of a thinly sliced biological specimen (kidney) was described. The thickness of the specimen was substantially 3 µm. For the substrate, fused quartz was used because its elastic properties are known and stable. The spherical acoustic lens was used to determine the position for the measurement. The frequencies of 400 and 600 MHz were used for the measurement and the visualization respectively. The generation of the Rayleigh waves in the above conditions was simulated by numerical calculations based on the wave propagation theory for layered media.
The First-Year Legal Writing Course: Praxis is Pivotal

This article suggests that the first-year legal writing class is important because it is the primary place where students engage in praxis by exercising judgment about both the means for accomplishing a legal task and the desired ends and enacting their knowledge, skills, and values.
Spreadsheets for stream processing with unbounded windows and partitions

Stream processing is a computational paradigm that allows the analysis of live data streams as they are produced. This paper describes a programming model, based on enhancements to spreadsheets, that enables users with limited programming experience to participate directly in the development of complex streaming applications. The programming model augments a conventional spreadsheet with streaming features that permit operating over unbounded data sets despite the finite interface provided by the spreadsheet. The new constructs include time-based windows and partitioning. We introduce a spreadsheet compiler that generates C++ code to achieve integration with existing stream processing systems. Our experimental study illustrates the expressivity of the new features and finds that our implementation is between 8x slower and 2x faster than hand-written stream programs.
Photodynamic therapy: Its use in the management of bronchogenic carcinoma

Photodynamic therapy is an investigational treatment of various types of carcinoma. It involves a photosensitizing agent which, when exposed to light of the proper wavelength, forms toxic oxygen radicals that result in cell death. This article describes its current use in the management of bronchogenic carcinoma.
A Developmental Perspective on Disgust: Implications for Obsessive-Compulsive Disorder

There has been an emergence of theoretical and empirical accounts on the nature and function of disgust in the literature. However, this literature has largely focused on adults. This article summarizes the literature on the emotion of disgust in children with emphasis on illuminating reactions to proposed disgust elicitors and the emergence of contamination concerns. Children’s understanding of disgust may represent the origins of individual differences in disgust proneness, a personality trait that is both genetic and a product of social learning. Early research employing multiple levels of analysis suggests that disgust proneness may confer risk for the development of obsessive-compulsive disorder (OCD) in children. Disgust proneness may originate, in part, from a distaste response that has been adapted to generalize to other stimuli as a means of facilitating avoidance. The implications of disgust proneness for the etiology and treatment of OCD are discussed as well as future directions for research.
Paleoecology of Snaketown

ABSTRACTThe following plant communities probably existed near Snake- town: creosote-bush, desert-saltbush, saltbush-arroweed, seepweed, mesquite thicket, and saguaro-paloverde. Agricultural activities promoted an increase in ragweed (Ambrosiae) as new land was incorporated into the irrigation system in the earlier phases. Irrigation fostered the extension of many riparian plant communities. Today upriver water storage has eliminated or disrupted the riparian plant communities and altered the ecology.
The Selective Origin of Linkage Disequilibrium in the HLA Region

The linkage disequilibrium patterns observed between tightly linked loci, such as the HLA loci, can indicate the nature of evolutionary events, particularly selection events, acting on the region. We have developed a method, disequilibrium pattern analysis, for examining the disequilibrium distribution of a population of two-locus haplotypes. Specific quantifiable patterns are predicted as a result of selective events.
Synovial sarcoma of the hypopharynx in a pediatric patient: Case report.

Abstract Introduction Synovial sarcoma (SS) is uncommon high grade soft tissue sarcoma, accounting for less than 10% of all head and neck sarcomas. Also, about 10% of SS occur within the Head & Neck. In the pediatric population, SS is an extremely rare head & neck malignancy. Presentation of case We present a case of sixteen years old boy diagnosed with SS situated of the hypopharynx treated by surgical excision and post operative radio-chemotherapy. Discussion This anatomical location brings additional functional challenges (swallowing, phonation, respiration), especially in the pediatric population. Pre-operative and even post-operative histopathological diagnosis of SS remains difficult. Optimal treatment of Head & Neck SS has to balance functional and oncologic aspects. Conclusion SS is an extremely rare head & neck malignancy in pediatric population. It has multifaceted challenges including pre and post-operative histopathological diagnosis and optimal modality of treatment. Clinical judgment, especially in the pediatric population, needs to balance tumor free margins and organ preservation in head and neck region.
Stochastic Model Predictive Control: An Overview and Perspectives for Future Research

Model predictive control (MPC) has demonstrated exceptional success for the high-performance control of complex systems [1], [2]. The conceptual simplicity of MPC as well as its ability to effectively cope with the complex dynamics of systems with multiple inputs and outputs, input and state/output constraints, and conflicting control objectives have made it an attractive multivariable constrained control approach [1]. MPC (a.k.a. receding-horizon control) solves an open-loop constrained optimal control problem (OCP) repeatedly in a receding-horizon manner [3]. The OCP is solved over a finite sequence of control actions {u0,u1,f,uN- 1} at every sampling time instant that the current state of the system is measured. The first element of the sequence of optimal control actions is applied to the system, and the computations are then repeated at the next sampling time. Thus, MPC replaces a feedback control law p(m), which can have formidable offline computation, with the repeated solution of an open-loop OCP [2]. In fact, repeated solution of the OCP confers an "implicit" feedback action to MPC to cope with system uncertainties and disturbances. Alternatively, explicit MPC approaches circumvent the need to solve an OCP online by deriving relationships for the optimal control actions in terms of an "explicit" function of the state and reference vectors. However, explicit MPC is not typically intended to replace standard MPC but, rather, to extend its area of application [4]-[6].
Malarial Landscapes in Late Antique Rome and the Tiber Valley

ABSTRACTUsing malaria and the watershed of the River Tiber as an example, this essay demonstrates how the principles of landscape epidemiology – taking the natural and human landscapes as a whole – can guide investigations into historic landscapes of disease. ‘Roman fevers’ have been legendary since Antiquity, and Italy’s malarial landscape was one of the most well known in the world. As this essay will illustrate, the Late Antique Tiber Valley was primed to support an intense malarial landscape continuing from Imperial Rome forward to medieval Italy with a continuing role in an urban syndemic, the convergence of two or more diseases into a larger problem. Studies by Sallares, Aldrete and others have provided the evidence needed to apply the principles of landscape epidemiology to Rome and the Tiber Valley. Taking into account climate, landscape features, animal species and human activity provides a more complete or holistic assessment of how an infectious disease functioned in the region.
Dynamics of soil CO2 efflux under varying atmospheric CO2 concentrations reveal dominance of slow processes.

We evaluated the effect on soil CO2 efflux (FCO2) of sudden changes in photosynthetic rates by altering CO2 concentration in plots subjected to +200 ppmv for 15 years. Five-day intervals of exposure to elevated CO2 (eCO2) ranging 1.0–1.8 times ambient did not affect FCO2. FCO2 did not decrease until 4 months after termination of the long-term eCO2 treatment, longer than the 10 days observed for decrease of FCO2 after experimental blocking of C flow to belowground, but shorter than the ~13 months it took for increase of FCO2 following the initiation of eCO2. The reduction of FCO2 upon termination of enrichment (~35%) cannot be explained by the reduction of leaf area (~15%) and associated carbohydrate production and allocation, suggesting a disproportionate contraction of the belowground ecosystem components; this was consistent with the reductions in base respiration and FCO2-temperature sensitivity. These asymmetric responses pose a tractable challenge to process-based models attempting to isolate the effect of individual processes on FCO2.
Multilevel Comparisons of Hospital Discharge among Older Adults with a Fall-Related Hospitalization.

Objective We examined multilevel factors associated with hospital discharge status among older adults suffering a fall-related hospitalization. Data Sources The 2011–2013 (n = 131,978) Texas Inpatient Hospital Discharge Public-Use File was used. Study Design/Methods Multilevel logistic regression analyses estimated the likelihood of being discharged to institutional settings versus home. Principal Findings Factors associated with a greater likelihood of being discharged to institutional settings versus home/self-care included being female, white, older, having greater risk of mortality, receiving care in a non-teaching hospital, having Medicare (versus Private) coverage, and being admitted from a non-health care facility (versus clinical referral). Conclusions Understanding risk factors for costly discharges to institutional settings enables targeted fall-prevention interventions with identification of at-risk groups and allows for identifying policy-related factors associated with discharge status.
Justification and Proper Basing

Some thirty or so years ago, Keith Lehrer attacked the idea that causation has much to do with knowledge or justification with the case of the gypsy lawyer, and has more recently endorsed the same kind of attack with the case of the racist scientist.’ These cases threaten not only causal theories of knowledge but also theories of knowledge or justification which require that one’s evidence be at least a partial cause of one’s belief. They threaten, that is, the view that causation is at the heart of the distinction between propositional justification, the justification one has for thecontentof one’s belief, and doxastic justification, the justification which attaches to the believing itself. When justification attaches to the believing itself rather than merely to the content of what is believed, it is because one holds the belief in questionon the basis ofthe evidence. When justification only attaches to propositional contents, there is a failure of such basing, e.g., one may have the evidence but believe for different reasons.
Preventable delays to intravenous furosemide administration in the emergency department prolong hospitalization for patients with acute heart failure

Abstract Background We sought to examine whether factors impacting the time to emergency department (ED) administration of intravenous (IV) furosemide were associated with the duration of hospital admission for patients with acute heart failure (AHF). Methods and results We conducted a single-center, retrospective analysis of patients presenting to the ED and admitted between January 1, 2007 and December 31, 2014 who received a dose of IV furosemide. A Cox proportional hazards model was used to examine the likelihood that a patient would be discharged home alive, adjusting for patient demographics, AHF severity (low, moderate, high), laboratory result timing, and known AHF confounders. We identified 695 patients who met study criteria with 430 (61.9%) in the low-severity group. In the overall model, every 60-minute delay in IV furosemide administration was associated with an 8% lower chance of successful discharge home relative to someone who received early furosemide (aHR 0.93, 95%CI 0.87, 0.98, P = 0.012). Subgroup analysis suggests this association was most impactful in low-acuity patients. Our adjusted analysis suggests delaying furosemide administration until after serum creatinine results resulted in a 41% lower chance of successful discharge home relative to someone who had furosemide administered prior to creatinine results (aHR 1.41, 95%CI 1.07, 1,84). Conclusions AHF patients, particularly those with lower severity, may benefit from rapid administration of IV furosemide in the ED. This suggests that a key determinant of hospital visit duration in this low-risk cohort is decongestion, which occurs sooner when IV therapy is begun early in the ED stay regardless of serum creatinine.
Economy in the Feeding of Infants

Food costs of different feeding patterns which meet recommended allowances for the first year of life may vary by as much as 100 per cent. Each family’s solution to the cost-benefit equation varies. Counseling and education by the physician on food costs, as well as on other aspects of infant feeding, are discussed.
Manipulating Query Expressions

The first step in answering a query posed to a data integration system is selecting which data sources are most relevant to the query. Performing this decision relies on a set of methods for manipulating queries and reasoning about relationships between queries. This chapter covers such reasoning techniques in detail. While these techniques are very useful in data integration, they are also of independent interest, and have been used in other contexts as well, such as query optimization and physical database design. After introducing the database terminology we use throughout the book, we discuss techniques for query unfolding , where the goal is to reformulate a query, possibly posed over other queries or views, so that it refers only to the database relations. We then describe in detail algorithms for query containment and query equivalence . Query containment is a fundamental ordering relationship that may hold between a pair of queries. If the query Q 1 contains the query Q 2, then the answers to Q 1 will always be a superset of the answers of Q 2 regardless of the state of the database. If two queries are equivalent, then they always produce the same answers, even though they may look different syntactically. We will use query containment and equivalence to decide whether two data sources are redundant with each other and whether a data source can be used to answer a query. Finally, we describe algorithms for answering queries using views . Intuitively, answering queries using views considers the following problem. Suppose you have stored the results of several queries into a set of views over a database. Now you receive a new query and you want to know whether you can answer the query using only the views, without accessing the original database. In the context of query optimization, finding a way to answer a query using a set of views can substantially reduce the amount of computation needed to answer the query. In the context of data integration we often describe a set of data sources as views over a mediated schema. User queries are formulated using the terms in the mediated schema. Hence, answering queries using views is necessary in order to reformulate user queries to refer to the data sources.
Structure Learning in Factored MDPs

In Chapter 5 we proposed a couple of subroutines, namely MLeM(S) and MLeM, that are tailored to model and exploit the unknown policy of a Markovian agent. Both of these subroutines assume prior knowledge of the possible set of features upon which a Markovian agent may base its policy, but not the exact set. For both of these subroutine, we pose the problem of modeling the unknown policy of a Markovian agent as learning the unknown feature space and transition function of an induced MDP (induced by the Markovian agent’s policy).
The phagocyte actin cytoskeleton

Publisher Summary This chapter describes the phagocyte actin cytoskeleton. Ultrastructural studies show that actin filaments in the macrophage cortical cytoplasm are organized into a three-dimensional network, which gives the cytoplasm the gel-like consistency noted by early light microscopists. Actin filaments are attached to the plasma membrane to form a submembranous meshwork that stabilizes the plasma membrane. Many agonists that generate movements induce a rapid and transient increase in polymerized actin. For example, when neutrophils are stimulated with the chemotactic peptide N-formyl-methionyl-leucyl-phenylalanine, phagocytizable particles, or phorbol esters, there is a transient increase in actin polymerization. Actin polymerization initiates the extension of the pseudopod, and generates protrusive force. Thus, the assembly and disassembly of the actin filaments are critical for the motile functions of leukocytes. Actin polymerization and network remodeling are modulated by actin regulatory proteins which respond to second messengers generated during agonist stimulation.
Analysis of the South Fork Dam and the Former Lake Conemaugh

Key objectives are outlined for the hydrologic calculations of the former Lake Conemaugh and the dam breach flood. Dam remnant survey data collected in 1889 were compared with the modern GPS reference frame. They differ by ~6.2 ft. (1.9 m), the 1889 data being systematically lower. At the moment the dam breached in 1889, the surface of Lake Conemaugh had an elevation in the range of ~492.5 to 492.6 m. Using LiDAR data and this lake stage, a storage-elevation curve was developed for the lake. The impoundment held about 1.455 × 107 m3 of water. The equivalent tonnage (14.3 million) is less than the usually cited figure of 20 million tons. Analysis of the South Fork watershed indicates that the time of concentration for runoff from the major rain event should have been in the range ~3.6 to 7.3 h, and the time to peak discharge less than 7.3 h. Observations of local streams suggest that rivers had peaked between 12 noon and 1:00 p.m. on the day of the flood, several hours before the dam breach.
Comorbidities and length of stay in chronic obstructive pulmonary disease patients.

Chronic Obstructive Pulmonary Disease (COPD) has a significant burden on patients and the healthcare system. There is a link between COPD and comorbidities such as congestive heart failure (CHF), f...
Does the Use of a Diabetes Electronic Medical Record Template Lead to Improvement of Screening for Complications of Type 1 Diabetes Mellitus in the Pediatric Population

Introduction: As per the Diabetes Control and Complications Trial the reduction of HbA1c from 9.8% to 8.1% can reduce the risk and progression of diabetes complications such as non-proliferative retinopathy by 53%, clinical neuropathy by 60% and microalbuminuria by 54%. There are multiple diabetes complication screening guidelines such as annual eye exams, foot exams, lipid levels, BMP, TFTs, and celiac screens. Many type 1 diabetic patients are not compliant with diabetes complication screening guidelines and providers are not often tracking patient compliance. An electronic database and template could remind providers to follow …
Botulinum Toxin A (BTA) Use in Abdominal Wall Re-construction: Initial Series and Early Results

Abdominal wall hernias are one of the most common clinical conditions faced by general surgeons.
Soil chemical and biological fertility, microbial community structure and dynamics in successive and fallow sugarcane planting systems

Sugarcane yields are declining under successive planting (monoculture) compared to other planting systems in Florida Histosols. To evaluate soil properties related to the sugarcane yield decline, a...
Outreach, Inreach, and The Age of Reason: Technology Education for a New Age of Learning

Educational institutions are in the middle of great changes following trends in demographics and broad availability of online education at comparatively infinitesimal costs for traditional and other students alike. While the response over time has been a combination of efforts we term Outreach and Inreach, we argue that a refreshed view on how education can be sustainably delivered in the future is required.
Thermodynamics and the matter of life

What is life? Seventy-five years after Erwin Schrodinger took up this fundamental human question, another physicist, Jeremy England, offers a bold update. His new book, Every Life Is on Fire, explores the physics of what makes some configurations of matter lifelike and others inert.
Memristor Based Neuromorphic Network Security System Capable of Online Incremental Learning and Anomaly Detection

Real-time network intrusion and anomaly detection systems designed for battery powered devices are in high demand. This paper presents a study of unsupervised and supervised memristor based neuromorphic systems for such tasks. AutoEncoder (AE) and Multilayer Perceptron (MLP) algorithms are used to design memristor based intrusion and anomaly detection systems. The autoencoder shows strong intrusion detection performance with accuracy greater than 92.5% on zeroday attack packets. A real-time online incremental learning and anomaly detection system is also designed using the effective anomaly detection abilities of the AE. The learning system uses two autoencoders, one AE is pretrained for classifying network packets as normal and malicious, and the second AE is initialized with random weights and learns malicious data incrementally. Thus, this system is able to flag new attack classes during runtime. The real-time intrusion detection system performs with an accuracy greater than 89.7%. The memristor based implementation shows that the proposed system can be implemented using extreme low power for edge and IoT applications.
Assata’s (Groove[ing]) Daughter: An Embodied Lyrical Autoethnography of Resistance:

This embodied lyrical autoethnography expands the look of freedom fighting. (Re)turning to a lasting mother–daughter lesson with new eyes and Assata Shakur’s insistence that liberation is a duty, i...
A clinician's guide to cutaneous T-cell lymphoma presenting as recalcitrant eczematous dermatitis in adults

Cutaneous T-cell lymphoma (CTCL) encompasses a group of low-grade, non-Hodgkin lymphoma, including mycosis fungoides and Sezary syndrome. Diagnosis of CTCL can be challenging given the prolonged, gradual onset and shared characteristics with many benign inflammatory skin diseases. In this case series, we describe four unique cases of patients with chronic, recalcitrant eczematous dermatitis who presented for a patch-test consultation and were ultimately diagnosed with CTCL. In particular, we highlight clinical pearls to aid in distinguishing CTCL from inflammatory dermatoses and describe the diagnostic strategy to help dermatologists arrive at the diagnosis of CTCL at earlier stages of the disease.
Development of a Novel Wireless Multi-Channel Stethograph System for Monitoring Cardiovascular and Cardiopulmonary Diseases

A multi-channel stethograph system was designed and developed as an electronic auscultation system for graphic recording of heart, lung, and trachea (HLT) sounds non-invasively through a set of 16 acoustic sensors. The multi-channel stethograph system was fabricated by placing 16 microphone based acoustic sensor in a CNC machined DelrinⓇhousing cases that are covered using diaphragms. Among the 16 acoustic sensors, 14 were positioned in a memory foam pad, and two were placed directly on the heart and trachea to acquire sounds simultaneously from the lungs, heart, and trachea. The sounds acquired from the 16 acoustic sensors were processed through a custom designed and fabricated 16-channel PCB for signal conditioning. A National Instruments (NI) 9205 data acquisition device (DAQ) along with a NI 9191 wireless chassis was used to acquire and wirelessly transmit the data from the 16-channel PCB to a Wi-Fi enabled device such as a PC/tablet. A custom LabVIEW program was developed on a Wi-Fi enabled PC/tablet to record the data from the DAQ. In addition, a MATLAB program was developed to convert the recorded data from the acoustic sensors into 16 audio files (for audio playback) and plot the waveforms in time and frequency domain as well as spectrogram for visual examination of any abnormal patterns in inhalation and exhalation. This provides critical information on the presence of crackles, rhonchi and wheeze sounds as well as abnormal heartbeat and respiration rate which helps in analyzing the condition of heart and lungs. The graphically displayed HLT sounds will help physicians in the clinical diagnosis and monitoring of lung and heart disorders, particularly chronic obstructive pulmonary disease (COPD), asthma, pneumonia, and congestive heart failure by providing objective evidence.
Constitutive gene expression differs in three brain regions important for cognition in neophobic and non-neophobic house sparrows (Passer domesticus)

Neophobia (aversion to new objects, food, and environments) is a personality trait that affects the ability of wildlife to adapt to new challenges and opportunities. Despite the ubiquity and importance of this trait, the molecular mechanisms underlying repeatable individual differences in neophobia in wild animals are poorly understood. We evaluated wild-caught house sparrows (Passer domesticus) for neophobia in the lab using novel object tests. We then selected the most and least neophobic individuals (n=3 of each) and extracted RNA from four brain regions involved in learning, memory, threat perception, and executive function: striatum, dorsomedial hippocampus, medial ventral arcopallium, and caudolateral nidopallium (NCL). Our analysis of differentially expressed genes (DEGs) used 11,889 gene regions annotated in the house sparrow reference genome for which we had an average of 25.7 million mapped reads/sample. PERMANOVA identified significant effects of brain region, phenotype (neophobic vs. non-neophobic), and a brain region by phenotype interaction. Comparing neophobic and non-neophobic birds revealed constitutive differences in DEGs in three of the four brain regions examined: hippocampus (12% of the transcriptome significantly differentially expressed), striatum (4%) and NCL (3%). DEGs included important known neuroendocrine mediators of learning, memory, executive function, and anxiety behavior, including serotonin receptor 5A, dopamine receptors 1, 2 and 5 (downregulated in neophobic birds), and estrogen receptor beta (upregulated in neophobic birds). These results suggest that some of the behavioral differences between phenotypes may be due to underlying gene expression differences in the brain. The large number of DEGs in neophobic and non-neophobic birds also implies that there are major differences in neural function between the two phenotypes that could affect a wide variety of behavioral traits beyond neophobia.
Minimum clinically important difference for the American Shoulder and Elbow Surgeons score after revision shoulder arthroplasty

Abstract Background Patients undergoing revision total shoulder arthroplasty (TSA) typically achieve smaller improvements in outcome measurements than those undergoing primary TSA. The minimum clinically important difference (MCID) in the American Shoulder and Elbow Surgeons (ASES) questionnaire for primary shoulder arthroplasty ranges from 13.6 to 20.9, but the MCID for revision shoulder arthroplasty remains unclear. This study aims to define the MCID in ASES score for revision TSA and ascertain patient factors that affect achieving the MCID threshold. Methods Patients were identified from an institutional shoulder arthroplasty database. Prospective data collected included demographic variables, prior shoulder surgeries, primary and revision implants, indication for revision, and pre- and postoperative ASES scores. All patients provided informed consent to participate. An anchor-based method was used with a binary answer choice. The MCID was calculated using the receiver-operator curve (ROC) method, and the sensitivity, specificity, and area under the curve were obtained from the ROC. MCID values were compared between groups using Student's t-test. Multivariate logistic regression modeling was used to determine significant predictors for reaching MCID. Significance was defined as P Results A total of 46 patients underwent revision TSA with minimum 2-year follow-up. The MCID using ROC method was 16.7 with 71% sensitivity and 62% specificity. There was a trend toward males being more likely to reach MCID after revision arthroplasty (P= .058). There were also trends toward increased forward flexion and abduction range of motion in patients who met MCID (P= .08, P= .07). Multivariate logistic regression modeling demonstrated male sex to be associated with achieving MCID (P= .03), while younger age and fewer prior shoulder surgeries demonstrated a trend to association with achieving MCID (P= .06, P= .10). Conclusion The MCID for ASES score in patients undergoing revision shoulder arthroplasty is similar to previously reported MCID values for patients undergoing primary shoulder arthroplasty. Younger, male patients with fewer prior shoulder surgeries were more likely to achieve MCID after revision TSA. Level of evidence Level III
Condyloma latum of the plantar foot: Case report of an unusual manifestation of secondary syphilis.

Condyloma lata, a cutaneous manifestation of secondary syphilis, typically presents as verrucous papules or plaques in the anogenital area. Here, we present a case of secondary syphilis presenting ...
Fatigue behavior of fine-grained magnesium under tension-tension loading at 0 °C

Abstract This study investigated low-temperature fatigue behavior of fine-grained magnesium through tension–tension fatigue testing at the temperature of 0 °C. The applied stress profiles of fatigue testing were selected to cover a wide range of loading conditions including low, medium, and high loading stresses. Even when the maximum applied stress of fatigue testing was as high as 88% of the ultimate tensile strength of the material, the corresponding fatigue life was long, i.e., 3973 cycles. Deformation accumulation per loading cycle reduced with the progression of fatigue testing for all studied loading conditions. Fatigue life analyses were performed using both Smith-Watson-Topper (SWT) model and Jahed-Varvani energy-based (JV) model. The fatigue life predictions through both models agree well with the experimental data.
Who is the Indian Learner of English? A Study in Learner Profile

English teachers will face existential peril if they fail to understand that their students are no longer students but learners and that they are the reason for teachers’ meaningful professional existence. The English classroom will be a site for successful enriching experience for both teachers as facilitators and students as learners only when the former understand the latter: who their learners are. Learner characteristics determine the materials and methods and classroom activities for use in class. They also determine the objectives of English language programme. Hence, it is imperative for English teachers to first understand learner characteristics of each English class as a pre-condition for meaningful interactive classroom. With the knowledge about their learners, teachers as facilitators can do much in negating the teacher-fronted classroom and bringing about a new learning-centred learning class. Learning-centric classroom is more significant and important than just learner-centred. After all, a classroom is not a collection of learners as if they are kept in a showcase. Much learning ought to take place with teachers acting as classroom managers and catalysts. The present study proposes to analyze the characteristics of Indian learners of English at the tertiary level through learner profiles personally collected over a period of time.
The Effect of Technology Usage Habits on Consumers' Intention to Continue Use Mobile Payments

With the arrival of the mobile commerce era, mobile payments have become one of the critical drivers for mobile commerce success. However, the percentage of consumers who use mobile payments frequently is still low. This research views IT acceptance from the IT ecosystem perspective and adopt transfer of learning theories as the theoretical background to investigate how technology usage habits affect consumers’ intention to continue use mobile payments. Results indicate that mobile service usage habit influence consumers’ behavioral intention directly and indirectly through mobile payment usage habit. In addition, consumers’ online shopping habit and cell phone usage habit influence their behavioral intention indirectly through mobile payment usage habit. Theoretical and practical implications of the findings are also presented.
2.2.1 Systems Integration: He Who Hesitates Is Lost

Most discussions on integration focus on the activities during the building of the product. Early actions are limited to defining and controlling the interface requirements. With the reality of the increased costs of fixing problems late in the program and the general recognition that there are usually problems at the interfaces, this seems to be a less than optimum approach. This paper looks at several ways to improve the overall integration process and find those problems much earlier. Examples are given of both need for earlier actions and their benefit.
Characterization of the 5′ flanking region of the rat D3 dopamine receptor gene

The D3 dopamine receptor has a restricted regional distribution in brain and is regulated by dopaminergic agents. Additionally, the D3 gene is implicated in the pathogenesis of several neuropsychiatric disorders or in their response to pharmacological agents. Elucidating its transcription control mechanisms is therefore of interest in order to explain these biological features of the D3 gene. In this study, the 5′ flanking region of the rat D3 gene was characterized by isolating the 5′ end of its cDNA as well as 4.6 kb of genomic sequence. Analysis of this region revealed the presence of two new exons 196-bp and 120-bp long, separated by an 855-bp intron, located several kilobases upstream of the previously published coding exons. Thus, current evidence indicates that the rat D3 gene is organized into eight exons. Transcription initiation site was determined by primer extension analysis and repeated rounds of 5′ RACE and was found to localize at a pyrimidine-rich consensus ‘initiator’ sequence, similar to the rat D2 gene. The D3 promoter lacks TATA or CAAT boxes but unlike that of other dopamine receptor genes has only 52% GC content. Functional analysis of D3 promoter deletion mutants fused to a reporter gene in TE671 cells, which endogenously express this gene, revealed strong transcriptional activity localized within 36 nucleotides upstream of transcription start site, and a potent silencer between bases −37 and −537. The D3 promoter is inactive in C6 and COS7 cells. We conclude that the D3 gene, similar to the closely related D2 gene, is transcribed from a tissue specific promoter which is under intense negative control.
Born series for (2 cluster) → (2 cluster) scattering of two, three, and four particle Schrödinger operators

We investigate elastic and inelastic (2 cluster) → (2 cluster) scattering for classes of two, three, and four body Schrodinger operators\(H = H_0 + \sum\limits_{i< j} {V_{ij} .} \) Formulas are derived for those generalized eigenfunctions ofH which correspond asymptotically in the past to two freely moving clusters. With these eigenfunctions, we establish a formula for the (2 cluster) → (2 cluster)T-matrix and prove the convergence of a Born series for theT-matrix at high energy.
The Experiences of Legally Married Same-Sex Couples in California

With the aim of increasing practitioner competence, this dissertation provides marriage and family therapists and mental health service providers with insight into the experiences of legally married same-sex couples. Specifically, the inquiry's objective was to elicit narratives of strength and agency from these couples who navigated the oppressive circumstances of an anti-gay amendment campaign situated within the debate over the extension of marriage rights to same-sex couples. Fourteen couples were interviewed in order to respond to the dissertation's overriding question: How do the lesbian and gay couples and families who are among those who were legally married in California before the passage of Proposition 8 narrate their experiences of their marriages? Through portraiture (Lawrence-Lightfoot & Davis, 1997), a method of inquiry situated within a postmodern, social constructionist framework, a narrative was produced which evolved through five emergent themes: 1) Our Commitments Have Rich Histories – the symbolic and legal ways in which these couples commemorated and brought definition to their commitments, in the absence of a nationally-sanctioned and collectively-recognized state of legal marriage; 2) Not a Simple Matter: The Complexities of Language Choice – their contextual language choices, which reflected the absence of representative and collectively-recognized language options for their relationships after their legal marriages; 3) The Battle Metaphor – the couples' experiences of California's political debate over the extension of marriage rights to same-sex couples; 4) Support Shaped Lived Experiences – the impact of support from friends, family, and community; and lastly, 5) Legal Marriage Shaped Individual, Relational, and Social Identities – individual, relational and social shifts that occurred for the couples through the experience of being legally married. A follow-up focus group further validated the theme Support Shaped Lived Experiences , and examined more deeply the tensions that occurred when important persons were silent about and/or did not recognize the legitimacy of the couples' legal marriages, and/or the discriminatory context in which their legal marriages were situated. In addition to its contribution of the experiences of legally married same-sex couples to the family therapy literature, the dissertation concludes with important implications for affirmative therapeutic practice, research, education, training, advocacy, and social policy.
Implementing a declination form programme to improve influenza vaccine uptake by staff in Department of Veterans Affairs spinal cord injury centres: a pilot study.

Summary Background Individuals with spinal cord injuries and disorders are at high risk for respiratory and influenza-related complications after developing influenza. These individuals often have frequent contact with the healthcare system. Vaccination rates in healthcare workers at Department of Veterans Affairs (VA) spinal cord injury (SCI) centres have been approximately 50% for several years. Efforts are needed to increase vaccination uptake among SCI HCWs. Declination form programmes (DFPs) in combination with other strategies have resulted in significant increases in influenza vaccination uptake in HCWs. Aim Use of external and internal facilitation including local teams and consensus processes to pilot a DFP in two VA SCI centres and evaluate factors influencing implementation. Methods Implementation meetings and a consensus-building process with leadership and implementation team members were conducted, along with semi-structured post-implementation interviews with members of each implementation team ( N = 7). Findings The DFP was well accepted and easy to use. Leadership was a key facilitator for DFP implementation. Barriers included difficulty communicating with HCWs working during early/late shifts. Participation was 100% at Site 1 and 48% at Site 2. Conclusion Use of local teams and consensus to identify strategies to implement a DFP is feasible and effective for achieving moderate-to-high levels of participation in the programme.
Observations sur la dégradation d'Hofmann appliquée à la gelsémine

Es wird gezeigt, dass der Hofmann'sche Abbau beim Gelsemin und einigen seiner Derivate nicht den normalen Verlauf nimmt. An Stelle von des-Basen werden Na-Methyl-gelsemin und die entsprechenden Derivate isoliert.