cssi/SciSciGPT-SciSciNet huggingface dataset:
High‐angle wave instability and emergent shoreline shapes: 2. Wave climate analysis and comparisons to nature

[1] Recent research has revealed that the plan view evolution of a coast due to gradients in alongshore sediment transport is highly dependant upon the angles at which waves approach the shore, giving rise to an instability in shoreline shape that can generate different types of naturally occurring coastal landforms, including capes, flying spits, and alongshore sand waves. This instability merely requires that alongshore sediment flux is maximized for a given deepwater wave angle, a maximum that occurs between 35 and 50 for several common alongshore sediment transport formulae. Here we introduce metrics that sum over records of wave data to quantify the long-term stability of wave climates and to investigate how wave climates change along a coast. For Long Point, a flying spit on the north shore of Lake Erie, Canada, wave climate metrics suggest that unstable waves have shaped the spit and, furthermore, that smaller-scale alongshore sand waves occur along the spit at the same locations where the wave climate becomes unstable. A shoreline aligned along the trend of the Carolina Capes, United States, would be dominated by high-angle waves; numerical simulations driven by a comparable wave climate develop a similarly shaped cuspate coast. Local wave climates along these simulated capes and the Carolina Capes show similar trends: Shoreline reorientation and shadowing from neighboring capes causes most of the coast to experience locally stable wave climates despite regional instability.
Impact of Linear Regulator Topology on Integrated Circuit Emissions

The type of linear, on-chip voltage regulator is important to the measured emissions from a device. A p-channel VREG is found superior to an n-channel VREG in terms of suppressing emissions from propagating from output voltage to the input voltage.
Adaptive clutter filtering via blind signal separation for lateral blood velocity measurement

A method for adaptive clutter rejection via blind signal separation (BSS) is presented in application to angle-independent blood velocity measurement in the carotid artery. Clutter filtering via frequency domain-based approaches is ineffective given short ensemble lengths and/or overlapping axial wall and lateral blood frequency spectra. Rather than operating in the frequency domain, BSS decomposes the input data ensemble into source signals in time. The method is demonstrated using Field II simulated and clinical examples of flow in the common carotid artery. In addition to clutter rejection, the BSS technique is presented for detection of small axial flow components and filtering acoustic radiation force impulse (ARFI) displacement profiles.
Ordered conformational change in the protein backbone: prediction of conformationally variable positions from sequence and low-resolution structural data.

Ordered conformational changes are an important structural property of proteins and are involved in a variety of fundamental biological activities. Large-scale analyses of the implications of such changes for protein function and dysfunction require efficient methods for automated recognition of conformationally variable residue positions. The goal of this work was to study sequence and low-resolution structural properties of residue positions that change backbone conformation upon changes in protein environment and the utility of these properties for automated recognition of such conformationally variable positions. This study was performed using a large nonredundant set of experimentally characterized proteins that undergo ordered conformational transitions obtained from the Database of Macromolecular Movements. The results of this study show that ordered changes in backbone conformation are not limited to solvent accessible loop regions. A considerable fraction of conformationally variable positions is observed in helices and strands, and in buried positions. Conformationally variable positions are less conserved in evolution. Local patterns of (a) sequence neighbors, (b) evolutionary conservation, and (c) solvent accessibility can be used to predict conformationally variable positions with balanced sensitivity and specificity, albeit with large variance at the level of individual proteins. However, including a pattern of secondary structure into the prediction scheme results in a highly unbalanced performance when all conformationally variable positions located in regular secondary structure are misclassified. Application of the present methodology to the prion protein (PrP) shows that conformationally variable positions predicted in its ordered C-terminal domain are located within segments presumed to be involved in refolding of PrP. Proteins 2008. © 2008 Wiley-Liss, Inc.
Air embolism in the agitated traumatic brain injury patient: an unusual complication

Central venous catheters are often utilized in the acute care management of the traumatic brain injury (TBI) patient. While in the agitated phase of recovery, TBI patients often focus on removing indwelling tubes or venous access lines. Air embolism is among the most serious complications reported in the use of central venous catheters. We present a case of air embolism in an agitated patient, and discuss prevention methodologies. A 38-year-old male was involved in a fall, with an initial Glasgow Coma Scale of 12. CAT scan imaging revealed a left frontal intracerebral haematoma. He required central venous catheter placement for management of associated chest and abdominal injuries. Agitated from early in his stay, the patient was able to twist off several hubs from the central venous catheter with his teeth, resulting in an air embolus. The patient experienced sudden clinical deterioration with oxygen saturation decling to 70%. The patient's course improved after several days of ventilatory support. He eventually successfully completed inpatient rehabilitation, achieving independence in activities of daily living and ambulation. This case illustrates a serious potential complication in the agitated patient. Physicians and rehabilitation specialists should advocate for secured taping of central venous catheter hubs and adequate padding of catheter dressings in agitated patients.
A time-shift model for OFDM radar

Active and passive detection using CP-OFDM modulated signals traditionally assume that targets do not move significantly during the entire observation period. In this paper, a “time-shift” model that compensates for the motion of targets between pulses during the observation period is introduced. Matched filtering based upon this model can be efficiently performed using a combination of the chirp-z transform and the fast Fourier transform algorithms. The resulting delay-Doppler plots are less “smeary” in the range axis than plots generated when using the traditional techniques over extended observation intervals, allowing better resolution of closely spaced targets.
The Emerging Music Business Model: Back to the Future?

For many years, the music industry has consisted of two main components: the concert industry and the recording music industry. Throughout the 80’s and 90’s, thanks mostly to CD sales, the recording music industry was dominant in terms of revenue and visibility. It reached record US sales in 1999 and 2000 (over $14.3 billion in 2000, $13.2 billion of which for CD albums), and between the years 2000 and 2007, the industry has seen a decline of 44% in its sales of physical records. Reluctantly, the recording industry has joined the digital world by signing agreements with a variety of organizations providing music downloading, in particular with Apple and its iTunes downloading service. It earned 1.4 billion dollars from music downloading in 2007 (with another billion from other digital sales such a cellular phone ringtones). Obviously, digital sales have fallen short of compensating the industry for its losses of physical record sales. The concert industry is re-emerging as the potential dominant component of the music industry. In contrast to the recording industry, its revenues have not been affected by illegal Internet downloading. On the contrary, it is making use of the Internet to increase them. Recording artists are taking advantage of the weakening of the recording labels and of the opportunities offered by the Internet to loosen their dependence on the labels. Finally, the once well-defined separation between the concert industry and the recording industry may be disappearing: concert organizers are getting into the recording business and majors are getting into the concert business.
Toward a communications satellite network for humanitarian relief

Since the introduction in 2008 of the "Ring Road" concept, proposing a communications satellite network designed to support disadvantaged populations, there have been a number of advances in the underlying technologies, CubeSat picosatellites and Delay-Tolerant Networking. We review the original Ring Road proposal, discuss relevant recent technological progress, and offer some tentative notes on projected cost and performance.
What contributions are invasive plant species making to ecosystem services

I nvasive plant species can establish in diverse environments, and, with the increase in human mobility, they are no longer restricted to isolated pockets in remote parts of the world. Cheatgrass ( Bromus tectorum L.) in rangelands, purple loosestrife ( Lythrum salicaria L.) in wetlands, and tamarisk ( Tamarix spp.) in riparian areas are examples of invasive plant species that are common to the United States and can be found in monocultures and patches covering many thousands of hectares. Across the world, invasive plant species like water hyacinth ( Eichhornia crassipes ), cogon grass ( Imperata cylindrica ), and mile-a-minute weed ( Persicaria perfoliata L.) have choked waterways, altered fire regimes, or caused the abandonment of farmland due to their dominating and persistent characteristics. Clearly, the effects of invasive plant species have reached global scales and their related costs have been estimated in the billions of dollars (Pejchar and Mooney 2009). While the control of invasive plant species is warranted in many natural and man-made environments, these species do provide services to these ecosystems, which have yet to be quantified on a range of scales. Ecosystem services are the benefits obtained from ecosystems and include provisional (e.g., food, water, fiber), regulating (e.g., carbon sequestration, waste decomposition, air purification, erosion…
Challenges in Conducting Family-Centered Mental Health Services Research.

In this article, the authors provide an analysis of the challenges facing researchers as they respond to the ideas that guide family-centered services and incorporate these themes into research focused on improving services for children with emotional, behavioral, or mental disorders and their families. The concept of “family-centered services” has emerged only recently as a generally well understood set of practice principles. Traditional approaches to conducting mental health research have not yet responded to the fundamental changes in thinking about service delivery evoked by a family-centered service system. The authors examine the fit between traditional mental health research and family-centered services and provide an introduction to the articles in this special issue.
Past-Year Intentional and Unintentional Injury Among Teens Treated in an Inner-City Emergency Department

An inner-city emergency department (ED) visit provides an opportunity for contact with high-risk adolescents to promote injury prevention. Objectives: To identify the prevalence of injuries sustained over the past year by teens presenting to an inner-city ED, and to identify factors associated with recent injury to inform future ED-based injury prevention initiatives. Methods: Over 1 year, 7 days a week, from 1:00-11:00 p.m., patients aged 14-18 years presenting to the ED participated in a survey regarding past-year risk behaviors and injuries. Results: Of the entire group of teens presenting to the ED (n = 1128) who completed the survey (83.8% response rate), 46% were male, and 58% were African-American. Past-year injuries were reported by 768 (68.1%) of the teens; 475 (61.8%) of those reported an unintentional injury and 293 (38.1%) reported an intentional injury. One-third of all youth seeking care reported a past-year sports-related injury (34.5%) or an injury related to driving or riding in a car (12.3%), and 8.2% reported a gun-related injury. Logistic regression found that binge drinking (adjusted odds ratio AOR. 1.95) and illicit weapon carrying (AOR 2.31) predicted a past-year intentional injury. African-American youth (AOR 0.56) and those receiving public assistance (AOR 0.73) were less likely to report past-year unintentional injuries. Conclusions: Adolescents seeking care in an inner-city ED, regardless of the reason for seeking care, report an elevated prevalence of recent injury, including violence. Future injury screening and prevention efforts should consider universal screening of all youth seeking ED care. Language: en
The Use of Accruals in Earnings Management: A Permanent Earnings Hypothesis

We suggest and present evidence that managers use discretionary accruals to smooth income around the managers' assessment of the firms' permanent earnings. We suggest that income smoothing is a long-term strategy which accomplishes multiple purposes. We form predictions regarding the direction of discretionary accruals in a given year by comparing income before discretionary accruals to the previous year's reported earnings. We further hypothesize and present evidence that earnings response coefficients which measure the extent to which reported earnings reflect the information used by the market in forming prices are higher for firms that engage consistently in income smoothing.
The flow shop problem with time lags and separated setup times

This paper generalizes Khurana-Bagga's flow-shop model which involves separated setup times and time lags where no restrictions are imposed on the processing and setup times as well as start and stop lags. It solves the two machine case and provides and approximate solution for the multimachine case. It also shows that Khurana-Bagga's algorithm is restricted to a special case of the two machine problem.
Assessment of Economic Viability of Mini-livestock Production in Delta State, Nigeria: Implication for Extension Delivery Services

The study examined the popularity, role and economic viability of mini-livestock keeping in Delta State, Nigeria. The specific objectives were to describe the socio-economic characteristics of mini-livestock farmers, identify the types of animals reared as mini-livestock in the area, ascertain the reasons for keeping mini-livestock by farmers, determine the benefit level of mini-livestock farmers, and identify the problems facing mini-livestock farmers in the study area. Using snowball sampling technique, 674 respondents were sampled with the aid of a structured questionnaire. Various descriptive and inferential statistics were used for data analyses. The results of the study indicated various types of mini-livestock reared in the study area, mainly snail farming or heliciculture (about 90%) and rearing of cane rat (84.27%); the most important reasons for keeping mini-livestock were income (99.6%), employment (99.26%) and food (94.96%). The result further indicated that protein consumption and improved income were the most important benefits to respondents. In spite of these benefits, the respondents faced some constraints, amongst which were lack of technical information (X=4.70), lacking of enough space for expansion (X=4.58), inadequate training (X=4.20), poor extension delivery services (X=4.20) and problems of feed availability (X=3.86). In spite of these constraints, the production of mini-livestock was found to be profitable in the study area. Based on the findings, it was recommended, among others, that mini-livestock farmers in the study area should be trained on various aspects of the management of mini-livestock especially by organising workshops for them.
Periodontics is the foundation for any other dental field

1986年笔者于原华西医科大学口腔系口腔颌面外科专业硕士毕业，在美国经过牙周专业研究生训练3年，至今，笔者已在美国西雅图做了12年牙周专科医师。口腔颌面外科的理论临床训练，特别是临床技能训练为牙周及种植手术奠定了坚实的基础。
RATIONALITY AND MORALITY

When we say that it is morally right to relieve famine victims, we are expressing our approval of famine relief and we are at least suggesting that people ought to come to the aid of those in danger of starvation. Morality is both expressive and normative as opposed to merely descriptive. So is rationality. When we say that it is rational for individuals to have medical insurance, we are expressing approval of doing so and suggesting that people ought to make sure they are insured. Similarly, to characterize a choice as irrational is usually to condemn it, and not simply to describe it. Not only are morality and rationality alike in these ways, but “rational” is often used (as in the previous example) as a synonym for “prudent,” and prudence is a morally admirable character trait or moral virtue. Yet morality and rationality are of course not the same thing. How are morality and rationality related? Is it always rational to be moral? These general philosophical questions are critical to understanding the relations between ethics and economics, because economics is built around a theory of rationality. We explore the relations between economics and rationality in Chapter 5 and between rationality, norms, and morality in Chapter 6. But first, Chapter 4 presents the standard theory of rationality and its extensions to circumstances of risk and uncertainty; it also considers some of the objections to which the theory has been subject.
Disability among older American Indians and Alaska Natives: disparities in prevalence, health-risk behaviors, obesity, and chronic conditions.

OBJECTIVES To estimate the prevalence of disabilities among older American Indians and Alaska Natives (AIANs) and compare these estimates with those of other major racial/ ethnic groups. To estimate, within the population with disabilities, the health-risk behaviors, obesity, and chronic conditions of older AIANs and compare them with estimates for other racial/ethnic groups. DESIGN State-based surveillance system that collects data on a monthly basis using an independent probability sample of households with telephones among the noninstitutionalized population aged > or =18 years. METHODS We analyzed data on 434,972 noninstitutionalized adults aged > or =50 years from the 2003-2005 Behavioral Risk Factor Surveillance System. RESULTS Among older AIAN adults, the unadjusted prevalence of disability (38.4%) was higher than among Whites (29.7%), Blacks (33.5%), Asians (15.6%), and Hispanics (26.9%). Among older adults with disabilities, AIANs were younger than their counterparts in other groups and were as likely to be male as female. After adjustment for age and self-rated health, both AIAN men and women with disabilities had the highest prevalence of current smoking, heart disease, and asthma. CONCLUSIONS Efforts to prevent, delay, and reduce disabilities and associated secondary conditions in persons with disabilities must be culturally sensitive and targeted toward reducing racial/ethnic disparities in health-risk behaviors and chronic conditions.
Approximate Feedback Linearization: Higher Order Approximate Integrating Factors

Abstract An approximate integrating factor for a nonintegrable one form is a scaling factor that makes the scaled one form closer to being integrable in some sense. In this paper we consider approximate integrating factors that scale a nonintegrable one form in a way that the scaled form is closer to being integrable in L2 together with some derivatives. One can decompose a given one-form into exact and inexact parts using the Hodge decomposition. We derive an upper bound on the size of the inexact part of a scaled characteristic one-form in the Sobolev space H2m and show that a least squares integrating factor of order 2m provides the minimum value for this upper bound. We show how one can use higher order approximate integrating factors in approximate feedback linearization of nonlinearizable single input affine systems.
Impact of APs selection scheme on compressive sensing-fingerprinting based IPS performance

Improving the accuracy of indoor positioning systems (IPS) has constantly been and still an active challenge. The Compressive Sensing (CS) approach has recently been shown to have a potential for indoor positioning systems (IPSs) solution once the positioning problem is modeled into a sparse signal recovery one. Indeed, positioning schemes using Received Signal Strength Indicator (RSSI) fingerprint maps and CS methods show remarkable improvements in performance. In this paper, we are presenting the impact of the Access Points (APs) selection scheme on the performance of both CS and k-Nearest Neighbor (k-NN) RSSI-based IPSs methods. The performance analysis has been investigated using three different APs selection schemes, namely, the Probability of Detection (POD), the Time Variance, and the Random selection schemes. Our simulation results show that the Random APs selection scheme outperforms POD and the Time Variance schemes when CS-based framework is used while k-NN outperforms CS with POD and Time Variance schemes. Results also show that CS outperforms the k-NN method under the same number of selected APs when using the Random APs selection.
Assessing Aβ Aggregation State by Atomic Force Microscopy

There has been a growing recognition of a wide variety of diseases commonly referred to as conformational diseases, which share the feature of specific disease-related proteins adopting nonnative conformation that promote their ordered aggregation and deposition on surfaces. Due to the nanoscale dimensions and the varied morphology of such aggregates, atomic force microscopy (AFM) has emerged as an ideal tool for distinguishing structural features of the numerous potential aggregate forms, ranging from small globular oligomers to large mature amyloid fibrils. Beyond the ability to morphologically distinguish aggregate forms, AFM also can dynamically track the aggregation process due to its unique ability to be operated not only in air (ex situ), but also in solution (in situ). This feature provides for tracking the fate of individual aggregates over time. This chapter describes the use of AFM in characterizing the aggregation of the amyloid-β peptide (Aβ), which is hypothesized to play a key role in Alzheimer's disease (AD), a late-onset neurodegenerative conformational disease.
“A pig and a garden”: Fannie Lou Hamer and the Freedom Farms Cooperative

ABSTRACTMuch of the scholarship on the work and legacy of activist Fannie Lou Hamer concentrates on her tireless efforts for civil/human rights and African American representation and access to electoral politics. This article brings to light an important project she started in 1969, Freedom Farms Cooperative (FFC) in Sunflower County, MS. An agricultural cooperative built on 680-acres, Freedom Farms included a pig bank, Head Start program, community gardens, commercial kitchen, a garment factory, sewing cooperative, tool bank, and low-income, affordable housing as strategies to support the needs of African Americans who were fired and evicted for exercising the right to vote. Freedom Farms offered these sharecroppers and tenant farmers educational and re-training opportunities including health care and disaster relief for those who wanted to stay in the Mississippi Delta. Using a historical method to analyze extensive archival records, this article offers an analysis of Freedom Farms and illuminates valu...
Modeling of Bernoulli production line with the rework loop for transient and steady-state analysis

Abstract Production system modeling (PSM) aims to reveal the fundamental principles of production procedures. Most of the research efforts for PSM focus on serial production lines, which is the most fundamental structure in a production system. However, modeling regarding more complex production systems is less developed. Decomposition methods are commonly used to study complex production lines; however, these approaches are only capable of handling steady-state situations. Current closed-form transient modeling cannot be directly applied to production systems with rework loops. In this paper, an analytical method for modeling a production system with a rework loop is presented. Furthermore, a novel ‘Self-View’ method is proposed for obtaining both transient and steady-state results. This research extends the PSM transient analysis to more complex production lines and overcomes restrictions of machine reliability and buffer capacity in the rework loop. The transient performance measures, i.e., the number of iterations and the settling time, are investigated. Moreover, sensitivity studies of starvation, blockage, production rate, and work-in-process on rework rate are conducted. As a result, the proposed ‘Self-View’ method in this research shows promising potential for modeling other complex production systems.
Temperament and Physical Activity in Childhood

Background: Temperament activity level can serve as a proxy for nondeliberate activity and an important part of overall energy expenditure. However, little is known about any association between temperament activity level and children’s levels of moderate- to vigorous-intensity physical activity. We examined whether temperament activity level in young children is associated with moderate- to vigorous-intensity physical activity later in childhood and midadolescence. We also assessed if parenting behaviors moderate any association. Methods: Data were obtained from 799 children and their mothers involved in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Growth curve analyses were used to examine the relationships over time, controlling for child and parent characteristics. Results: High temperament activity level at age 4.5 was associated with higher moderate- to vigorous-intensity physical activity at age 9 (β = 5.15; SE =2.47; P < .001). The a...
Unmanned ground vehicle simulation with the Virtual Autonomous Navigation Environment

Unmanned and autonomous ground vehicles have the potential to revolutionize military and civilian navigation. Military vehicles, however, present unique challenges related to autonomous navigation that are not encountered in civilian applications. These include a high percentage of off-road navigation, navigation in hostile environments, navigation in GPS-denied environments, and navigation in urban environments where little data regarding road networks are available. These unique challenges require a deliberate approach for developing robust, reliable autonomous and unmanned systems that features extensive testing for performance and safety features in a wide variety of environments and conditions. In order to enable this approach, we developed a computational tool for simulating and predicting the performance of unmanned and autonomous ground vehicles in realistic environmental conditions. This tool, the Virtual Autonomous Navigation Environment, is discussed in this paper.
Relationship of circulating spexin with markers of cardiovascular disease: a pilot study in adolescents with obesity.

SummaryPurpose Spexin, a novel peptide, has potential implications in obesity, satiety and energy homeostasis. The current study examined the relationship of spexin with various biomarkers of cardiovascular disease and endothelial function in adolescents with obesity. Methods Nineteen adolescents with obesity (age, 15.8 ± 1.7 years) were studied. Spexin, leptin and various cardiovascular disease biomarkers were measured. Endothelial function was assessed by high-resolution Doppler ultrasonography of the right brachial artery. Results Spexin concentration (median [interquartile range] 0.38 ng/mL [0.29–0.59 ng/mL]) was inversely correlated (r = −0.50, P = 0.03) with leptin. When participants were clustered into two groups (‘high spexin and low leptin’ vs. ‘low spexin and high leptin’), the odds of having ‘low spexin and high leptin’ in participants with higher hs-CRP (≥ 3 mg/L) were 12.25 times (95 per cent CI −1 to139, P = 0.026) higher than those of participants with lower hs-CRP (<3 mg/L). Spexin levels, however, were not associated with measures of endothelial function. Conclusions The inverse association between spexin and leptin and the presence of higher concentrations of hs-CRP in adolescents with obesity in the setting of ‘low spexin and high leptin’ suggest a potential role for spexin in the regulation of satiety and certain cardiovascular risk factors in children with obesity.
El papel de las ONGs en el sistema de la Corte Penal Internacional

The International Criminal Court would not exist as it is currently known without NGOs. After promoting its creation and participating decisively in the negotiation of its Statute, NGOs are in third moment of synergy. NGOs play a key role in the functioning of the Criminal Court, which sometimes needs them to carry out its functions. The present research analyzes this relationship in order to detect its deficiencies and to study how to articulate an effective cooperation.
Temporal dynamics of gut microbiota in triclocarban-exposed weaned rats.

Widely used as an antimicrobial in antibacterial bar soaps, triclocarban (3,4,4′-trichlorocarbanilide; TCC) is effective against Gram-positive bacteria but shows little efficacy against Gram-negative strains, potentially altering the composition of indigenous microflora within and on the human body. To date, the consequence of continuous or previous nonprescription antimicrobial exposure from compounds in personal care products on commensal microflora is still elusive. Previous research has shown that TCC exposure during gestation and lactation induced dysbiosis of gut microbial communities among exposed dams and neonates. However, the impact of antimicrobial exposure specifically after discontinuation of the use of TCC on the gut microbiota has not been investigated. In this study, weaned Sprague Dawley rats (postnatal day, PND 22) were provided ad lib access to TCC-supplemented diet (0.2% w/w or 0.5% w/w) for 4 weeks (phase I) followed by a 4-week washout period (phase II) to determine gut microflora changes both during continuous exposure to TCC and to determine the potential rebound following TCC withdrawal. Fecal samples were collected at baseline (PND 22) prior to TCC exposure and throughout phase I and phase II. The V4 region of 16S rDNA was sequenced from extracted total fecal DNA with the MiSeq platform. Exposure to both 0.2% w/w and 0.5% w/w TCC was sufficient to alter diversity of microbiota during phase I of treatment. This effect was further prolonged into phase II, even when TCC exposure was discontinued. Collectively, these data highlight the impact of both continuous and prior TCC exposure on gut microbial ecology and shed light onto the potential long-term health risk of daily nonprescription antimicrobial personal care product use.
Overcoming barriers to diabetes care in the hospital: The power of qualitative observations to promote positive change.

Aims Despite advocacy by diabetes societies and evidence about how to prevent the deleterious consequences of dysglycemia among hospitalized patients, deficits in clinical practice continue to present barriers to care. The purpose of this study was to examine inpatient rounding practices using a qualitative research lens to assess challenges on the care of hospitalized patients with diabetes and to develop ideas for positive changes in hospital management of diabetes and hyperglycemia. Methods We conducted an interpretive analysis of qualitative observations during medical and surgical inpatient rounds at an academic institution. We coded, analysed, and reported data as thematic findings. Results Emerging themes include omissions in discussions during rounds; unpreparedness to address diabetes or dysglycemia during rounds; identifying practice improvement opportunities to address diabetes issues: and recognizing accountability within the routine of practice. Conclusions This work guides clinicians and informs systems of practice about improvement strategies that can emerge from within hospital teams. These recommendations emphasize the interconnectedness of practice elements including thoughtful review of glucose status during rounds among patients with and without diabetes; fostering doctors and nurses to work in unison; promoting awareness and integration within and across disciplines; and advocating for better use of existing resources.
Feasibility and Cost Analysis of Day 4 Granulocyte Colony-Stimulating Factor Mobilized Peripheral Blood Progenitor Cell Collection from HLA-Matched Sibling Donors

Introduction Published guidelines recommend 6-7 days of G-CSF followed by peripheral blood progenitor cell (PBPC) collection on day 5. Given successful PBPC collection occurs in some autologous transplants by day 4, and concern that a subset of healthy allogeneic donors may be maximally mobilized before day 5, we performed a feasibility study evaluating day 4 allogeneic PBPC collection. Methods This single-center prospective study included adult patients with malignant diseases receiving first allogeneic stem cell transplant between 7/1/2013 – 6/30/2017. HLA-matched sibling donors received 10 μg/kg G-CSF subcutaneously prior to PBPC collection. Donors collected on day 4 of G-CSF if peripheral blood (PB) CD34+ counts were ≥0.04 × 106/ml, and on day 5 if Results 101 patients/donors were eligible for inclusion, with 75 in the historical cohort. Target collection was ≥4 × 106 CD34+ PBPC/kg recipient weight. Of the 101 donors on study, 50 (49.5%) had adequate collection on day 4, 26 (25.7%) collected on day 5, and 25 (24.8%) required two-day collections. Median day 4 PB CD34+ cell count was 0.06 (range 0.03-0.13) × 106/ml for donors collected on day 4, 0.03 (0.007-0.09) × 106/ml for day 5, and 0.019 (0.004-0.04) × 106/ml for two-day collections (p Median collected (7.25 × 106/kg recipient weight) and infused (5.67 × 106/kg recipient weight) PBPC product CD34+ cell counts were significantly greater in day 4 products. In comparison, infused total nucleated (7.13 × 108/kg recipient weight), mononuclear (5.84 × 108/kg recipient weight), and CD3+ (2.14 × 108/kg recipient weight) cell counts were significantly lower in day 4 products. Compared to the historical cohort, donors with day 4 collection were significantly more likely to develop bone pain, require narcotics, and over-the-counter medications. There were no significant differences in time to neutrophil or platelet engraftment, or in the incidence of acute or chronic GVHD. Cost analysis revealed a 6.7% savings in direct costs per collection procedure for the day 4 collection method versus historical cohort. Conclusions Approximately 50% of healthy sibling donors can generate adequate PBPC collection when using a day 4 PB CD34+ threshold of ≥0.04 × 106/ml. While differences in PBPC product composition and donor symptoms were seen based on day of collection, we found no evidence of adverse post-HCT outcomes associated with day 4 PBPC collection. Day 4 may be the optimal day of stem cell collection for a population of healthy donors, without adverse effect on transplant outcomes, and with an anticipated cost savings. These findings merit further analysis in larger HCT cohorts.
Diagnostic Techniques: Ultrasonography

Ophthalmic ultrasonography is essential for documentation, measurement, and differentiation of intraocular tumors. It is a safe, noninvasive diagnostic technique providing instant images for interpretation. Standardized echography refers to the combined use of contact B-scan and standardized A-scan. It provides a reliable method to evaluate ocular lesions based on the topographic, quantitative, and kinetic properties of the echo intensities and patterns. Topographic, quantitative, and kinetic features of many intraocular tumors are well established. B-scan and UBM examination yield topographic information including shape, size, and location as well as vascularity, a kinetic feature. Diagnostic A-scan examination yields quantitative information including structure and reflectivity and in some instances vascularity. Utilizing these combined techniques (standardized echography), malignant intraocular tumors can be differentiated from benign lesions whose appearance on visual examination may be similar.
It’s Complicated: Marital Ambivalence on Ambulatory Blood Pressure and Daily Interpersonal Functioning

Marriage decreases cardiovascular morbidity although relationship quality matters. While some marriages contain highly positive aspects (supportive), marriages may also simultaneously contain both positive and negative aspects (ambivalent). Individuals whose spouses or own behavior is ambivalent may not experience the same cardiovascular-protective benefits of marriage. The purpose of this study is to elucidate the physiological pathways by which marital quality may influence long-term health and examine ambivalent behavior on interpersonal-functioning and ambulatory blood pressure (ABP). Interpersonal functioning and ABP were examined in 94 couples. Spousal and own ambivalent behavior was associated with lower intimacy (ps < .01) and higher systolic ABP (ps < .01). Spousal ambivalent behavior was associated with lower ratings of partner responsiveness (p < .01) and less self- and spousal-disclosure (ps < .05). Mediational analyses indicated that own behavior mediated links between spousal ambivalent behavior and ABP. Despite the positivity in relationships, individuals whose spouses’ or own behavior is ambivalent may not receive cardiovascular protection from this positivity.
Quantitative Investing and Market Instability

The May 2010 Flash Crash and August 2007 Quant Meltdown raised concerns about the impact of quantitative investment strategies on market instability. We examine whether quantitative investing dampens or exacerbates market instability by focusing on mutual fund fire sales. We find that quantitative fund fire sales have a much larger impact on market instability than fire sales by traditional mutual funds. For the same magnitude fire sale, quantitative funds’ impact is over eight times as large. The larger impact is due to quantitative funds’ reliance on similar trading strategies and their strategies’ sensitivity to the time-series of returns.
Sequence Variant and Posttranslational Modification Analysis During Cell Line Selection via High-Throughput Peptide Mapping.

Selection of high-producing lead and backup cell lines with high-fidelity primary structure is a major goal of cell line development of protein therapeutics. Conventional techniques for sequence variant analysis, such as mass spectrometry (MS) and next-generation sequencing (NGS) have limitations on the sample number and turnaround time, thus often are only applied at the final stages of development, where an undesired lead or backup clone could cause a significant delay in project timeline. Here we presented a high-throughput (HT) peptide mapping workflow which can be applied at early stages of cell line selection for testing of a batch of 30–40 clones within 2-week turnaround while reporting valuable information on sequence variants and posttranslational modifications (PTMs). The successful application of this workflow was demonstrated for two mAb programs. Multiple clones were removed from a total of 33 mAb-1 clones using various criteria: nine clones contained at least one >1% upregulated unknown peptide ions, 11 clones contained at least eight >0.1% upregulated unknowns, and six clones contained upregulated critical PTMs. For mAb-2, light chain (LC) sequence extension of approximately 30 amino acids were detected in 6 out of 36 clones at levels up to 11%. Besides, a Q to H mutation at ~30% was detected in the heavy chain (HC) of a single clone. Q to H mutation has mass change of 9.00 Da and failed to be detected by intact mass analysis. Rapid PTM quantitation also facilitated the selection of clones with desirable quality attributes, such as N-glycan profile. Hence, we demonstrated a risk-reducing strategy where abnormal clones could be detected at earlier stages of cell line selection, which should result in reduced and more predictable timeline of cell line development.
Indexing Character in the Context of Sport Participation Within the United States Military Academy: The Character in Sport Index

AbstractOrganized sports are an important context for promoting character, and the particular values emphasized illuminate how a setting develops or reveals character. The Character in Sport Index ...
De Novo Lipogenesis as a Source of Second Messengers in Adipocytes

Obesity is a major risk factor for type 2 diabetes. Although adipose tissue allows storage of excess calories in periods of overnutrition, in obesity, adipose tissue metabolism becomes dysregulated and can promote metabolic diseases. This review discusses recent advances in understandings how adipocyte metabolism impacts metabolic homeostasis. The ability of adipocytes to synthesize lipids from glucose is a marker of metabolic fitness, e.g., low de novo lipogenesis (DNL) in adipocytes correlates with insulin resistance in obesity. Adipocyte DNL may promote synthesis of special “insulin sensitizing” signaling lipids that act hormonally. However, each metabolic intermediate in the DNL pathway (i.e., citrate, acetyl-CoA, malonyl-CoA, and palmitate) also has second messenger functions. Mounting evidence suggests these signaling functions may also be important for maintaining healthy adipocytes. While adipocyte DNL contributes to lipid storage, lipid precursors may have additional second messenger functions critical for maintaining adipocyte health, and thus systemic metabolic homeostasis.
Spinal cord injury

Abstract The spinal cord has a limited potential to regenerate after traumatic injury, due to extensive tissue destruction and a natural healing process, which creates physical, cellular, and molecular barriers in an attempt to preserve residual function. In this chapter, we focus on tissue-engineering approaches that use biomaterials as combinatorial therapies for spinal cord injury (SCI) repair. SCI is first described as the disruption of anatomic organization, along with its clinical and epidemiological consequences. Key tissue-engineering principles to facilitate spinal cord regeneration using biomaterial platforms in multimodal approaches are discussed. Bioengineering considerations for material fabrication in macro- and microarchitectures, and for integrated biocompatibility in animal models of SCI are addressed. The applications of natural and synthetic polymer scaffolds with cellular and molecular functionalization, and their outcomes in regenerating spinal cord tissue after injury, are presented in detail. The chapter concludes with perspectives on the clinical translation of these technologies to improve neurologic function in patients with SCI.
Time-Driven activity-based costing identifies opportunities for process efficiency and cost optimization for robot-assisted laparoscopic pyeloplasty.

Summary Background Robot-assisted laparoscopic pyeloplasty (RALP) is a commonly performed procedure in children, but its actual cost implications on the healthcare ecosystem have not been adequately defined. Time-driven activity-based costing (TDABC) is a novel cost accounting method derived from value based healthcare systems that may offer one pathway to assess institutional costs. Objective To determine the true cost of a robot-assisted laparoscopic pyeloplasty (RALP) in the pediatric population using TDABC, and compare it to traditional cost accounting. And to utilize TDABC to minimize cost and improve time-flow efficiency. Subjects/patients and methods The RALP care pathway was defined from patient arrival to the pre-operative suite to discharge from the post-anesthesia care unit (PACU). Process maps were created with an interdisciplinary team to survey RALP activities. Retrospective time stamps were obtained from the electronic medical record for fiscal year 2016 (FY16) RALP cases, and were validated by prospectively stopwatch timing additional RALP cases. Male and female pediatric patients undergoing a unilateral RALP during FY16 and during the prospective study period (June 2017–October 2017) were included. Procedure costs were calculated using TDABC after determining the capacity cost rate for all personnel and assets, and multiplying them with the time stamps. Results 25 RALP cases were analyzed for FY16. TDABC determined a total cost of $15 319/case, when direct, indirect and capital robot cost are included. Traditional cost accounting amounted to a total of $16 158/case. The current robot utilization rate is 22% of total capacity, effectively increasing the total RALP cost by 16%. Time stamps with the most variance were pre-operative services (115 ± 27.5 min), robotic console (142 min ±30.7 min) and PACU times (145 ± 101.1 min) (Figure) Discussion This study represents the first TDABC implementation in robot-assisted pediatric procedures. Previous TDABC in other areas of urology similarly revealed discrepancies between traditional cost accounting and TDABC. The present study demonstrates a higher total cost than previous cost accounting studies for the RALP, however, this is the first effort to include indirect costs in the final calculations. This study does convey the limitations of a retrospective analysis and those inherent to a single institution study. Conclusion TDABC defined the magnitude of cost variation based on robot utilization of a RALP. Traditional cost accounting overestimates the actual costs of a RALP. TDABC also identified high-cost and high variability loci in the RALP process map that will be targeted for process and quality improvement while further reducing assessed costs. Download : Download high-res image (159KB) Download : Download full-size image Summary Fig. . Direct variable activity costs of a RALP with mean times (minutes) and standard deviations
Torsional oscillators and the entropy dilemma of putative supersolid 4He

Solid 4He is viewed as a nearly perfect Debye solid. Yet, recent calorimetry measurements by the PSU group (J. Low Temp. Phys. 138, 853 (2005) and Nature 449, 1025 (2007)) indicate that at low temperatures the specific heat has both cubic and linear contributions. These features appear in the same temperature range where measurements of the torsional oscillator period suggest a supersolid transition. We analyze the specific heat and compare the measured with the estimated entropy for a proposed supersolid transition with 1% superfluid fraction and find that the observed entropy is too small. We suggest that the low-temperature linear term in the specific heat is due to a glassy state that develops at low temperatures and is caused by a distribution of tunneling systems in the crystal. We propose that dislocation related defects produce those tunneling systems. Further, we argue that the reported putative mass decoupling, that means an increase in the oscillator frequency, is consistent with a glass-like transition. The glass scenario offers an alternative interpretation of the torsional oscillator experiments in contrast to the supersolid scenario of nonclassical rotational inertia.