cssi/SciSciGPT-SciSciNet huggingface dataset:
Surfactant phospholipid catabolic rate is pool size dependent in mice

We increased surfactant pool size by surfactant treatment in mice to test if the catabolism of the major component of surfactant, saturated phosphatidylcholine (Sat PC), was rate limited. By intratracheal instillation, we gave mice trace doses, doses of 45 or 110 μmol/kg, or three doses of 110 μmol/kg of Sat PC in surfactant that contained radiolabeled dipalmitoylphosphatidylcholine (DPPC) and a radiolabeled phospholipase A-resistant ether analog of DPPC. Two strains of mice with 2-fold differences in alveolar and total Sat PC pool sizes were used; the mice with the higher pool sizes had a 2.3-fold higher steady-state catabolic rate. Acute increases in alveolar surfactant given by intratracheal instillation increased catabolic rates ∼2-fold over the steady-state rates in both strains. There was minimal loss of the ether analog of DPPC from the lungs, and the alveolar macrophages did not accumulate more than 10% of the ether analog. In these two strains of mice, the catabolism of Sat PC was not rate limited because catabolic rate increased when alveolar pool sizes were increased.
Evaluation of IgG molecules, Fab' fragments and IgG‐horseradish peroxidase conjugates as surface labels for freeze‐etched membranes

Sheep red blood cell (SRBC) ghosts were incubated with preparations of anti-SRBC IgG, antigen-binding fragments of IgG (Fab') or IgG coupled to horseradish peroxidase (HRPO). Frozen samples of the labelled ghosts were deep-etched and replicated with platinum-carbon to visualize their surface features in the transmission electron microscope. The surfaces of control ghosts contain a very low number of 'background' particles (42 +/- 8 particles/micron 2) that vary in size from 4.5 to 25 nm. After labelling with whole IgG the density of surface particles (average diameter 12.3 nm) increases dramatically to 480 +/- 54 per micron 2. Fab'-labelled ghosts exhibited both significantly fewer (87 +/- 14 particles/micron 2) and smaller (average diameter 9.8 nm) surface particles. Ghosts labelled with IgG-HRPO conjugates possessed 590 +/- 45 particles/micron 2 with an average diameter of 15.3 nm. When these ghosts were incubated with diaminobenzidine and hydrogen peroxide the average size but not the density of the particles increased. Based on these and other observations we conclude that an organic surface marker for freeze-etched membranes has to have a diameter of greater than 15 nm if it is to be consistently seen over extended areas and against the background granularity of the surface of a red blood cell ghost. Somewhat better resolution may be expected if markers consisting of inorganic crystals with a distinct shape and coupled to Fab' fragments can be made.
Machining Force Modeling of Vibration-Assisted Nano-Machining Process

Nanofabrication technology is very important for many emerging engineering and scientific applications. Among different nanofabrication technologies, vibration-assisted nano-machining provides a low cost easy-to-setup approach to produce structures with nano-scale resolution. It is critical to understand the mechanism for the nano-machining process and predict the cutting force, so as to provide guidelines to achieve higher productivity and reduce tip wear. In this article, a machining force model for tip-based nano-machining process is developed and validated. We analyze the instantaneous engagement area between cutting tool (AFM tip) and workpiece (PMMA film) at the given tip position for the vibration-assisted nano-machining process. A discrete voxel method is adopted to calculate the material removal rate at each moment, and an empirical machining force model is developed by correlating the cutting force with material removal rate. The model was verified by experiments over a large range of machining conditions, and the coefficients and parameters in the force model was obtained using Mean Square Error (MSE) method by comparing the predicted machining force from the force model and measured machining force from experiments. The results show good fit between predicted machining force and measured machining force.Copyright © 2015 by ASME
Augmentation of myocardial blood flow in hypertensive heart disease by angiotensin antagonists: a comparison of lisinopril and losartan.

Abstract Objectives The goal of this study was to compare myocardial perfusion reserve (MPR) before and after long-term treatment with lisinopril and losartan in patients with hypertension and left ventricular hypertrophy (LVH). Background Studies have suggested that treatment with angiotensin-converting enzyme inhibitors (ACEIs) improves MPR in patients with hypertension by potentiating endogenous bradykinins. Because angiotensin receptor blockers (ARBs) lack a direct effect on bradykinins, we hypothesized that they may not improve MPR. Methods We measured pre- and post-treatment myocardial blood flow (MBF) by positron emission tomography in 17 patients (lisinopril: 9 patients, losartan: 8 patients) with hypertension and LVH at baseline and after coronary vasodilation with intravenous dipyridamole. In addition, we measured rest and hyperemic blood flow in eight normotensive controls. Results Post-treatment maximal coronary blood flow and MPR in the lisinopril group increased significantly compared with pretreatment values (3.5 ± 1.2 vs. 2.6 ± 1.1 ml/min/g, p = 0.02; 3.7 ± 1.1 vs. 2.4 ± 1 ml/min/g, respectively, p = 0.002, respectively). Post-treatment hyperemic flow in the patients treated with lisinopril was not significantly different from corresponding measurements in controls (3.5 ± 1.2 vs. 3.9 ± 1 ml/min/g, respectively, p = NS). In the patients treated with losartan, there was no difference between pre- and post-treatment MBF values and MPR. Conclusions Myocardial perfusion reserve and maximal coronary flow improved in asymptomatic patients with hypertension-induced LVH after long-term treatment with lisinopril but not with losartan. Thus, ACEIs, but not ARBs, might be effective in repairing the coronary microangiopathy associated with hypertension-induced LVH.
Justification in Ethics

Normative ethics is believed by some to be on shaky ground, mainly because two aspects of ethical justification have seemed resistant to solution. One problem concerns how to reason validly from conflicting ethical principles to case resolution. It has been claimed that contemporary normative ethics offers no satisfactory basis for weighing such principles[17]. The other problem involves identifying the ultimate grounds of moral judgments. It has been asserted that the various time-honored theories of normative ethics are uniformly without foundation and that, consequently, we appear unable to arrive at a systematic knowledge of good and evil [21]. In this paper I hope to show that normative ethics — specifically, medical ethics — is indeed viable, that it has substance. I shall attempt to do this by suggesting a method of justification that seems to handle these two problems adequately.
A Method to Measure Viscosity of Fluids in Microchannels

In this paper, we present a microfluidic-based rheometer that uses in-situ pressure signals to measure the shear viscosity of liquids. The shear-viscosity is measured using a PDMS-based microfluidic device that consists of a channel layer and a sensing membrane integrated with an array of piezoresistive pressure sensors via plasma surface-treatment. The micro-pressure sensors are fabricated using conducting particles-PDMS composites, synthesized by mixing 82 wt% micrometer-sized silver particles (1–3 μm in diameter) with PDMS gels. The simple design and fabrication enable nearly perfect bonding of a 120 μm-thick sensing membrane to different channel geometries that map the pressure differences at various locations within the channel in order to measure the fluid shear stress in-situ and to estimate the fluid viscosity. Experimental validation of this microfluidic-based rheometer is performed using calibration oil of known viscosity as well as macroscopic rheometric data, both of which achieve good consistency. The present work allows in-situ measurements of rheological properties of fluids at low Re.© 2012 ASME
Paper 13: Bevel and Hypoid Gear Surface Durability: Pitting and Scuffing

This paper presents formulae and charts to show the effects of various parameters on pitting, scuffing and sliding. It also includes results of laboratory and field tests.
Genetics of the hyperlipidemias and cardiovascular implications.

Among the risk factors implicated in the development of atherosclerotic cardiovascular disease, one of the most important is hyperlipidemia, i.e., an increased plasma concentration of either cholesterol or triglycerides or both. A variety of epidemiological studies have shown that both hypercholesterolemia and hypertriglyceridemia are associated with increased risk of developing ischemic heart disease (IHD); the association of hyperlipidemia with premature IHD is even more striking. Longitudinal, prospective data from the general population on the presence of hyperlipidemia early in life and its effect on the development of premature IHD in adulthood are not currently available. One approach is therefore to concentrate on those families in which inherited disorders of lipid and lipoprotein metabolism and IHD co-exist. The thrust of this discussion will therefore be on these familial diseases and their early biochemical, genetic and clinical presentations with an emphasis on their cardiovascular implications.
Virion Glycoprotein-Mediated Immune Evasion by Human Cytomegalovirus: a Sticky Virus Makes a Slick Getaway

The prototypic herpesvirus human cytomegalovirus (CMV) exhibits the extraordinary ability to establish latency and maintain a chronic infection throughout the life of its human host. This is even more remarkable considering the robust adaptive immune response elicited by infection and reactivation from latency. In addition to the ability of CMV to exist in a quiescent latent state, its persistence is enabled by a large repertoire of viral proteins that subvert immune defense mechanisms, such as NK cell activation and major histocompatibility complex antigen presentation, within the cell. However, dissemination outside the cell presents a unique existential challenge to the CMV virion, which is studded with antigenic glycoprotein complexes targeted by a potent neutralizing antibody response. The CMV virion envelope proteins, which are critical mediators of cell attachment and entry, possess various characteristics that can mitigate the humoral immune response and prevent viral clearance. Here we review the CMV glycoprotein complexes crucial for cell attachment and entry and propose inherent properties of these proteins involved in evading the CMV humoral immune response. These include viral glycoprotein polymorphism, epitope competition, Fc receptor-mediated endocytosis, glycan shielding, and cell-to-cell spread. The consequences of CMV virion glycoprotein-mediated immune evasion have a major impact on persistence of the virus in the population, and a comprehensive understanding of these evasion strategies will assist in designing effective CMV biologics and vaccines to limit CMV-associated disease.
Following the money

In 1271 a 17-year-old boy called Marco Polo embarked on an adventure that took him from his hometown of Venice, across Europe, the Middle East and Asia, all the way to Beijing. He returned home 24 years later, having travelled over 24 000 km. A trip of this magnitude was unprecedented in Polo's time; almost 750 years later, he is rightly remembered for it. But what was an exception in medieval Italy is today an everyday occurrence: our 21st-century world is on the move. Every year, more than three billion passengers use the international air-transportation network, flying on a complex web of routes that connects more than 3000 airports worldwide. This global connectivity has made it possible for people to go from virtually any place on the planet to any other within a matter of days.
Promoting Student Development of Models and Scientific Inquiry Skills in Acid-Base Chemistry: An Important Skill Development in Preparation for AP Chemistry

In this study, two groups of 11th grade chemistry students (n = 210) performed a sequence of hands-on and virtual laboratories that were progressively more inquiry-based. One-half of the students did the laboratory sequence with the addition of a teacher-led discussion connecting student data to student-generated visual representations of different acid–base models (Arrehenius and Bronsted–Lowry). Students were assessed for perceptions about their learning as well as their understanding of acid–base models. The results showed improvement in 79% of the students in understanding acid–base chemistry following the inquiry laboratories as well as improved mental models explaining acid–base chemistry in 72% of the students. The students also responded favorably to the addition of virtual laboratories, with 77% reporting improved understanding of the chemistry as a result of the addition of the technology.
Methodology: Reconstructive Dialectics

A proper philosophical analysis provides a complete and consistent systematization of concepts for the description and explanation of things (objects) and their modifications over time. The concepts can be logical, epistemological, metaphysical, ontological, ethical, or even political; the things can be persons, collectivities, physical objects, mental objects, or even transcendent objects.1 My suggestion will be that the resolution of some of the quandaries about action theory can be addressed by a dialectical analysis how action concepts relate to means and ends. A reconstructive dialectics explicates the concepts involved in the actions. Such an approach can resolve some of the epistemic and normative inconsistencies manifest in some of the problems raised in the last chapter about neo-pragmatic action theory.
Ultrasound-Guided Spinal Procedures for Pain: A Review

As the population ages, more patients are developing degenerative changes of the spine and associated pain. Although interventional procedures for axial and radicular spine pain have been available for decades, common imaging modalities have relied on ionizing radiation for guidance. Over the past decade, ultrasound has become increasingly popular to image both peripheral musculoskeletal and axial structures. This article reviews the use of ultrasound in the guidance of spine procedures, including cervical and lumbar facet injections and medial branch blocks, third occipital nerve blocks, thoracic facet and costotransverse joint injections, sacroiliac joint injections, and caudal and interlaminar epidural injections.
Commentary on: Incidence and Risk Factors for Major Surgical Site Infections in Aesthetic Surgery: Analysis of 129,007 Patients.

The prevalence of aesthetic surgical procedures continues to rise with nearly 2 million procedures performed in the United States in 2015 and an increase of $1.5 billion since 2014.1 This expansion of the field underscores the importance of ongoing evaluation of safety, including the risk of surgical site infections (SSI). Previous studies of SSIs following aesthetic surgical procedures have been limited by relatively small sample sizes, use of data from single centers, inclusion of data from surgeries done more than 20 years ago, and/or a focus on a single type of procedure.2 The current study by Kaoutzanis et al contributes significantly to the literature because it includes over 129,000 patients undergoing 24 different aesthetic surgery procedures across the United States from 2008 to 2013.3 The large sample of contemporary patients, the ability to evaluate infection risk for individual procedures, procedure categories, and multiple simultaneous procedures, and the exploration of risk factors such as smoking, diabetes, and obesity distinguish this study from prior efforts. The authors used the CosmetAssure™ database to identify patient variables for 24 covered aesthetic procedures performed by enrolled surgeons. Surgeons must be either board-certified or board-eligible in plastic surgery to participate in the CosmetAssure™ private insurance program, which is now available in all 50 states (after an expansion that took place during the study period). Using information submitted by these providers, the authors assessed risk factors for the occurrence of major SSI, defined as necessitating emergency room visit, hospital admission, or reoperation within 30 days of the initial surgery. Overall, they found a low risk of major SSI (0.46%), which was lower than both the majority of previously …
The Triad of Sleep Apnea, Hypertension, and Chronic Kidney Disease: A Spectrum of Common Pathology

Obstructive sleep apnea (OSA), hypertension, and chronic kidney disease (CKD) are different entities and are generally managed individually most of the time. However, CKD, OSA, and hypertension share many common risk factors and it is not uncommon to see this complex triad together. In fact, they share similar pathophysiology and have been interlinked with each other. The common pathophysiology includes chronic volume overload, hyperaldosteronism, increased sympathetic activity, endothelial dysfunction, and increased inflammatory markers. The combination of this triad has significant negative impact on the cardiovascular health, and increases the mortality and morbidity in this complicated group of patients. On one hand, progression of CKD can lead to the worsening of OSA and hypertension; similarly, worsening sleep apnea can make the hypertension difficult to treat and enhance the progression of CKD. This review article highlights the bidirectional interlink among these apparently different disease processes which share common pathophysiological mechanisms and emphasizes the importance of treating them collectively to improve outcomes.
Instrumental variable estimation for nonlinear factor analysis

A general nonlinear model for factor analysis is proposed and discussed. Issues associated with the use of the model are discussed, including the identification problem. A single-equation model fitting procedure based on instrumental variable approach is introduced. The procedure includes an adjustment designed to reduce the bias due to the nonlinearity of the model. Theoretical results based on the small-error asymptotics are presented in support of the procedure and the bias adjustment. An illustrative example is also given.
Combined screening for early and late pre-eclampsia and intrauterine growth restriction by maternal history, uterine artery Doppler, mean arterial pressure and biochemical markers.

Background Pre-eclampsia is a systemic disease connected with high maternal and fetal morbidity and mortality. Despite significant progress achieved in perinatal medicine, pre-eclampsia is still one of the most significant current problems in obstetrics. Objectives The aim of the study was to establish diagnostic algorithms for early and late pre-eclampsia (PE) and intrauterine growth restriction (IUGR). Material and methods A total of 320 pregnant women between 11 + 0 and 13 + 6 weeks of gestation were recruited for a case-control study. The study group consisted of 22 patients with early PE, 29 patients with late PE and 269 unaffected controls. The following parameters were recorded: maternal history, mean arterial pressure (MAP), mean uterine artery pulsatility index (UtA-PI), and the concentrations of placental growth factor (PlGF), pregnancy-associated plasma protein A (PAPP-A) and free beta-human chorionic gonadotropin (free β-hCG). Results A multivariable stepwise logistic regression analysis indicated that the best screening model for the prediction of early PE is based on a combined analysis of maternal risk factors, UtA-PI and PlGF levels (sensitivity: 91%; specificity: 84%). The best screening model for the prediction of late PE is based on a combined analysis of maternal risk factors, UtA-PI and MAP (sensitivity: 85%; specificity: 83%). The most effective screening model for the prediction of IUGR is based on a combined analysis of maternal risk factors, UtA-PI and PlGF concentrations (sensitivity: 91%; specificity: 83%). Conclusions The integrated model of screening established in this study can be a valuable method to identify patients at increased risk of developing pre-eclampsia and related complications. The ability to predict the occurrence of pre-eclampsia in early pregnancy would enable maternal and fetal morbidity to be reduced through the introduction of strict obstetric surveillance as well as planned delivery in a reference center.
Integrating Self-Care Into Nursing Education

The didactic and clinical components of the mental health curriculum content within a school of nursing in the southeastern United States were revised to integrate a self-care focus. The major learning modalities used were group process dynamics and a structured psychoeducation approach. A six-hour per quarter credit course was divided into three parts: theory, laboratory, and clinical. Students averaged 3 hours in class, 2 hours in a simulated college laboratory, and 7 hours at a clinical site per week for one quarter. Theoretical concepts were taught during class time; self-care activities and concepts were taught in the college laboratory; and clinical time was devoted to practicing self-care through patient-nurse interactions and group work. Nurse educators may use this study to guide curriculum development in fostering caring models of nursing education.
The Role of Innovation in Education for Sustainable Peace

The overarching goal of this chapter is to examine the role of innovation in education for sustainable peace. In order to elaborate on innovation, the chapter looks at the Montessori method of education, which places an emphasis on promoting the humanistic values of free inquiry, trust-building, and an awareness of oneself, others, and the environment. Afterwards, the chapter proceeds to discuss art, study-abroad programs, and virtual and/or online platforms as innovative strategies for promoting sustainable peace.
Effects of purified human fibrinogen modified with carbon monoxide and iron on coagulation in rabbits injected with Crotalus atrox venom

While snake venom derived enzymes, such as the thrombin-like activity possessing ancrod, have been used to treat thrombotic disease by defibrinogenating patients, the therapeutic potential of fibrinogenolytic snake venom enzymes, such as those derived from Crotalus atrox, have not been fully explored. However, one of the potential risks of administering fibrinogenolytic enzymes to effect defibrinogenation is hemorrhage secondary to hypofibrinogenemia. The present investigation sought to determine if human fibrinogen modified with carbon monoxide (CO) and iron (Fe) could resist degradation by C. atrox venom as has been seen in vitro in a recently developed rabbit model of envenomation. Compared with unmodified human fibrinogen, CO/Fe modified fibrinogen administered prior to envenomation had significantly shorter onset of coagulation and greater strength; however, when administered after envenomation, there was no differences between the two types of fibrinogen. Of interest, when administered after envenomation, both types of fibrinogen delayed the onset of coagulation while increasing plasma clot strength, a mixed effect likely secondary to formation of fibrinogen degradation products. Further preclinical investigations are needed to further define the benefits and risks of the use of fibrinogenolytic enzymes as defibrinogenating agents, as well as the risks of the "biochemical brakes" used to modulate the activity or substrate of the fibrinogenolytic enzyme.
From Radical Adult Education to Social Movement Learning

Holst traces the changing nature of social justice-oriented adult education from the days of radical adult education to contemporary social movement learning. The chapter relates the changing descriptors of lifelong education and learning for social change to the changes in social movements themselves and the broader socio-political economic contexts in which they take place. The chapter argues that the concepts of new social movements and old social movements do not capture the nature of growing contemporary social movements among dispossessed sectors of society. Today, educators must have a clear understanding of the nature of polarization caused by neoliberal globalization in order to confront the challenges and understand the revolutionary potential for social movement learning in the new emerging movements.
Smectic viral capsids and the aneurysm instability

The capsids of certain Archaea-infecting viruses undergo large shape changes, while maintaining their integrity against rupture by osmotic pressure. We propose that these capsids are in a smectic liquid crystalline state, with the capsid proteins assembling along spirals. We show that smectic capsids are intrinsically stabilized against the formation of localized bulges with non-zero Gauss curvature while still allowing for large-scale cooperative shape transformation that involves global changes in the Gauss curvature.
Nonhuman primate models of human viral infections

Humans have a close phylogenetic relationship with nonhuman primates (NHPs) and share many physiological parallels, such as highly similar immune systems, with them. Importantly, NHPs can be infected with many human or related simian viruses. In many cases, viruses replicate in the same cell types as in humans, and infections are often associated with the same pathologies. In addition, many reagents that are used to study the human immune response cross-react with NHP molecules. As such, NHPs are often used as models to study viral vaccine efficacy and antiviral therapeutic safety and efficacy and to understand aspects of viral pathogenesis. With several emerging viral infections becoming epidemic, NHPs are proving to be a very beneficial benchmark for investigating human viral infections.
Reducing Medication Dispensing Process Time in a Multi-Hospital Health System

The process of prescribing, ordering, transcribing, and dispensing medications is a complex process and should efficiently service the high volume of daily physician orders in hospitals. As demand for prescriptions continues to grow, the primary issue confronting the pharmacists is overloading in dispensing the medication and tackling the mistakes caused by misinterpretation of the prescriptions. In this paper, we compared two prescribing technologies, namely no carbon required (NCR) and digital scanning technologies to quantify the advantages of the medication ordering, transcribing, and dispensing process in a multi-hospital health system. NCR technology uses a four parts physician order form with no carbon required copies, and digital scanning technology uses a single part physician order form. Results indicated a reduction of 54.5 % in queue time, 32.4 % in order entry time, 76.9 % in outgoing delay time, and 67.7 % in outgoing transit time in digital scanning technology. Also, we present the cost analysis to justify the acquisition of the Medication Order Management System (MOMS) to implement digital scanning technology.
Analysis of Calcium Transport in Rat Intestine

Transmural calcium absorption is the resultant of two processes: a saturable, regulatable process that traverses the cell and a non-saturable, non-regulated process that is largely paracellular. This article will summarize findings and analyses in support of this generalization and provide details of the action of vitamin D, the primary regulator of active calcium absorption.
Consciousness: a brief review of the riddle.

As I look at the full moon on a clear night, light travels between the moon and me in just over 1 second, enters my eyes and is focused on my retina, stimulating the photoreceptors, and … stops! That is as far as the moonlight goes. From here on, information about the moon travels the optic pathways of cranial nerves and brain—3 pounds in weight, 2 billion neurons, and upwards of 500 trillion synapses. Silently and in total darkness, a visual image is produced and projected back into space to clothe the object of my gaze so that it seems that the light shines directly from the moon into my mind's eye. This illusion is so exquisite that I hardly recognize it as such. The moon now exists in my visual consciousness. But where is this awareness and where am “I”? More important, am “I” an observer of this occurrence or an integral part of it? Dualists claim mind and brain to be separate while materialists argue that the mind is the brain and that man has no immaterial part. Dualists and materialists have been dueling for centuries. At the present time, materialists seem to have the upper hand, but the fight is far from finished and the final answer may turn out to be a surprise for everyone.
Enumeration of Vibrio species, including V. cholerae, from samples of an oyster growing area, Grays Harbor, Washington

Water, shellfish, and sediment samples from Grays Harbor, a major commercial oyster producing estuary in the State of Washington, were examined for levels of Vibrio species. Non-01 V. cholerae was found at low levels in 37.8% of the samples. While V. parahaemolyticus was found in all samples, levels were low. V. mimicus and V. fluvialis were found infrequently and at low levels. Potentially pathogenic strains of non-01 V. cholerae and Kanagawa positive V. parahaemolyticus were isolated from oysters suggesting a potential for human illness.
On the sub-optimality of single-letter coding in multi-terminal communications

We investigate binary block-codes (BBC). A BBC is defined as a vector of Boolean functions. We consider BBCs which are generated randomly, and using single-letter distributions. We characterize the vector of dependency spectrums of these BBCs. We use this vector to upper-bound the correlation between the outputs of two distributed BBCs. Finally, the upper-bound is used to show that the large blocklength single-letter coding schemes in the literature are sub-optimal in some multiterminal communication settings.
Prenatal polyunsaturated fatty acids and child asthma: Effect modification by maternal asthma and child sex.

Background Findings on prenatal polyunsaturated fatty acid (PUFA) intake and child wheeze and asthma have been inconsistent. Objective We sought to examine associations between prenatal PUFA status and child wheeze/asthma and modifying effects of maternal asthma/atopy, child sex, and maternal race. Methods Analyses included 1019 mother-child dyads with omega-3 (n-3) and omega-3 (n-6) PUFAs measured in second-trimester plasma; n-6/n-3 ratios were calculated. Child wheeze/asthma outcomes ascertained at age 4 to 6 years included ever physician-diagnosed asthma, current wheeze (symptoms past 12 months), current asthma (diagnosis and medication and/or symptoms past 12 months), and current diagnosed asthma. Each PUFA indicator and outcome was analyzed in separate models using modified Poisson regression with interaction terms. Results In quartile (Q) analyses, higher n-6 PUFAs were associated with increased risk of ever (risk ratio [RR] high vs low [RR Q4 vs Q1], 1.70; 95% CI, 1.07-2.71) and current (RR Q4 vs Q1, 1.70; 95% CI, 1.07-2.71) diagnosed asthma, whereas n-3 PUFAs were associated with lower risk (RR Q4 vs Q1, 0.59; 95% CI, 0.33-1.03) of current diagnosed asthma (Ptrend Conclusions Associations between prenatal PUFA status and childhood wheeze/asthma were modified by maternal history of asthma and child sex.
Stable isotope compositions of herbivore teeth indicate climatic stability leading into the mid-Miocene Climatic Optimum, in Idaho, U.S.A

Abstract The effects of global climate change are manifested at the regional level; consequently, evaluation of links between palaeoenvironmental change and turnover of past biotas must use regional-scale climate data. Here we test whether climate change influenced faunal and floral patterns leading up to, and during, the mid-Miocene Climatic Optimum (MMCO) based on datasets collected in the Railroad Canyon section (RCS), central-eastern Idaho, U.S.A. Specifically, we use isotope compositions of herbivore tooth enamel to investigate how Mean Annual Precipitation (MAP), Mean Annual Temperature (MAT), Cold Month Mean Temperature (CMMT), and temperature seasonality varied through the RCS and how this local record compares to global climate reconstructions. Isotope compositions of teeth from the fossil equid Merychippus and rhinocerotid Diceratherium were compared across five time bins from c. 23 to c. 15 Ma. Bulk δ18O values of both taxa indicate that meteoric water compositions were unchanged through the study interval (consistently c. −15.6‰) but were c. 1.9‰ higher than current regional meteoric water. This difference points to warmer climates in central-eastern Idaho during the Miocene, post-middle Miocene topographic uplift in western North America, and/or shifts to air mass trajectories. Serial sampling of enamel shows seasonal fluctuations in water compositions and temperature. Bulk δ13C values indicate an average MAP of 190 (range: 10–510 mm·yr−1), with no significant change through the study interval, comparable to today's MAP (236 mm·yr−1). The reconstructed semi-arid, seasonal, warm climate for the RCS agrees with phytolith assemblage data from the same strata indicating dominantly open, grassy habitats. However, it is inconsistent with previously held ideas of warm-wet mid-Miocene climates in the northern Rocky Mountains (NRM) based on paleosol analyses. Our inferred, stable climate conditions for the MMCO of the NRM contrast with coeval records from Europe and Asia indicating sustained or enhanced warm and wet climates. These differences point to a decoupling of regional climate from global trends and highlight the necessity of studying regional variation to understand the biotic impacts of global climate change.
The effect of hypersonic nonlinear aerodynamic loading on panel flutter.

The system considered is a two-dimensional isotropic panel, or plate-column, on hinged supports, with one end spring restrained in the plane of the panel. Panel geometric nonlinearities and piston-theory aerodynamic nonlinearities are included. Results from an earlier preliminary study indicate that only two second-order nonlinear aerodynamic terms are important. The nonlinear aerodynamic terms introduce the possibility of an amplitude-sensitive instability, where the panel is unstable to disturbances of a certain magnitude but stable for smaller ones. This type of instability is examined for various panel in-plane loads and initial conditions, with other parameters having values representative of current practice. A single new interaction parameter, representing the importance of the nonlinear aerodynamic terms in comparison with the panel geometric nonlinear terms, is introduced. A parameter survey is presented, involving this parameter and the static pressure difference across the panel. Finally, the practical impact of this type of instability is discussed.
Prescribing systemic steroids for acute respiratory tract infections in United States outpatient settings: A nationwide population-based cohort study.

BACKGROUND Evidence and guidelines do not support use of systemic steroids for acute respiratory tract infections (ARTIs), but such practice appears common. We aim to quantify such use and determine its predictors. METHODS AND FINDINGS We conducted a cohort study based on a large United States national commercial claims database, the IBM MarketScan, to identify patients aged 18-64 years with an ARTI diagnosis (acute bronchitis, sinusitis, pharyngitis, otitis media, allergic rhinitis, influenza, pneumonia, and unspecified upper respiratory infections) recorded in ambulatory visits from 2007 to 2016. We excluded those with systemic steroid use in the prior year and an extensive list of steroid-indicated conditions, including asthma, chronic obstructive pulmonary disease, and various autoimmune diseases. We calculated the proportion receiving systemic steroids within 7 days of the ARTI diagnosis and determined its significant predictors. We identified 9,763,710 patients with an eligible ARTI encounter (mean age 39.6, female 56.0%) and found 11.8% were prescribed systemic steroids (46.1% parenteral, 47.3% oral, 6.6% both). All ARTI diagnoses but influenza predicted receiving systemic steroids. There was high geographical variability: the adjusted odds ratio (aOR) of receiving parenteral steroids was 14.48 (95% confidence interval [CI] 14.23-14.72, p < 0.001) comparing southern versus northeastern US. The corresponding aOR was 1.68 (95% CI 1.66-1.69, p < 0.001) for oral steroids. Other positive predictors for prescribing included emergency department (ED) or urgent care settings (versus regular office), otolaryngologist/ED doctors (versus primary care), fewer comorbidities, and older patient age. There was an increasing trend from 2007 to 2016 (aOR 1.93 [95% CI 1.91-1.95] comparing 2016 to 2007, p < 0.001). Our findings are based on patients between 18 and 64 years old with commercial medical insurance and may not be generalizable to older or uninsured populations. CONCLUSIONS In this study, we found that systemic steroid use in ARTI is common with a great geographical variability. These findings call for an effective education program about this practice, which does not have a clear clinical net benefit.
Extreme-value analysis for the characterization of extremes in water resources: A generalized workflow and case study on New Mexico monsoon precipitation

Abstract Water managers need non-stationary tools to better characterize precipitation extremes. Statistical approaches based on extreme value theory (EVT) are increasingly being used, but few end-to-end generalized workflows are available. In this paper, a step-by-step framework is demonstrated for developing an EVT model that considers the influence of dominant weather patterns on precipitation extremes in a watershed. Specifically, the Point Process (PP) model is utilized, which is a unified statistical framework for modeling the frequency and magnitude of extremes above a threshold. Because threshold selection can be subjective, a demonstration of how to go about selecting a threshold is provided; in particular, by examining a range of thresholds. The workflow is applied to daily precipitation from the Rio Grande watershed in New Mexico. In this arid watershed, extreme precipitation events substantially contribute to total runoff. An improved understanding of the drivers and extent of changes in extreme precipitation is essential for water resource and risk management. In addition to a stationary PP model without covariates, several covariates are examined for inclusion in the location and scale parameters. The significance of including the covariates is assessed, as well as several additional criteria, including if the covariate(s) make intuitive sense and if it is a good candidate for statistical downscaling (i.e., methods that relate large-scale variables to the local scale). A final PP model is selected that includes the wet weather types in the location and scale parameters. This model is applied in a downscaling context using a large ensemble of climate projections, which shows that the frequency of exceeding a high threshold increases after 2050, but the conditional likelihood of exceeding the maximum observed precipitation stays relatively constant.
Power-law Statistics of Driven Reconnection in the Magnetically Closed Corona

Numerous observations have revealed that power-law distributions are ubiquitous in energetic solar processes. Hard X-rays, soft X-rays, extreme ultraviolet radiation, and radio waves all display power-law frequency distributions. Since magnetic reconnection is the driving mechanism for many energetic solar phenomena, it is likely that reconnection events themselves display such power-law distributions. In this work, we perform numerical simulations of the solar corona driven by simple convective motions at the photospheric level. Using temperature changes, current distributions, and Poynting fluxes as proxies for heating, we demonstrate that energetic events occurring in our simulation display power-law frequency distributions, with slopes in good agreement with observations. We suggest that the braiding-associated reconnection in the corona can be understood in terms of a self-organized criticality model driven by convective rotational motions similar to those observed at the photosphere.
Basic Issues and Concepts in the Career Development and Counseling of Women

Although the focus of this book is on career counseling for women, it presumes that the reader has a basic, working knowledge of the major theories of and approaches to career development and career counseling. The field of vocational psychology is nearly 100 years old, if Frank Parsons’ groundbreaking work, Choosing a Vocation (1909), can be considered its birth. Since then we have built a rich tradition of theory, research, and counseling methods, including methods of vocational and career assessment. Accordingly, I assume a familiarity with the theories of Super (see Super, Savickas, & Super, 1996), Holland (see Spokane & Cruza-Guet, 2005), Dawis and Lofquist (Dawis, 2005), Gottfredson (Gottfredson, 2005), Krumboltz’ social learning approach (Mitchell & Krumboltz, 1996), and Lent, Brown, and Hackett’s (1994, 2000; Lent, 2005) social cognitive theory and with traditional methods of career assessment in the areas of abilities and aptitudes, vocational interests, and vocational needs and values. Readers who wish to expand or review their knowledge in these areas may consult such resources as Brown and Lent’s (2005) Career Development and Counseling, Osipow and Fitzgerald’s classic text Theories of Career Development (1996), the Handbook of Vocational Psychology (Walsh & Osipow, 1995), the Handbook of Counseling Psychology (Brown & Lent, 2000), Swanson and Fouad’s (1999) Career Theory and Practice, Spokane’s (1991) Career Intervention, and Luzzo’s (2000) Career Counseling With College Students.
Germline DNA Replication Shapes the Recombination Landscape in Mammals

Genetic recombination generates novel trait combinations and understanding how recombination is distributed across the genome is key to modern genetics. The PRDM9 protein defines recombination hotspots, however megabase-scale recombination patterning is independent of PRDM9. The single round of DNA replication, which precedes recombination in meiosis, may establish these patterns, therefore we devised a novel approach to study meiotic replication that includes robust and sensitive mapping of replication origins. We find that meiotic DNA replication is distinct; reduced origin firing slows replication in meiosis and a distinctive replication pattern in human males underlies the sub-telomeric increase in recombination. We detected a robust correlation between replication and both contemporary and ancestral recombination and found that replication origin density coupled with chromosome size determines the recombination potential of individual chromosomes. Our findings and methods have far-reaching implications for understanding the mechanisms underlying DNA replication, genetic recombination, and the landscape of mammalian germline variation.
Diagnosis of Stage III Periodontitis and Ambiguities of the "Gray Zones" in Between Stage III and Stage IV.

INTRODUCTION How to best classify the Stage III and IV periodontitis cases that share common features of the most severe clinical attachment loss and the most severe radiographic bone loss? CASE PRESENTATION Two patients presented features of generalized periodontitis, with severe probing depth and clinical attachment loss that would meet inclusion in both Stage III and IV. The cases retained all teeth but were further complicated by teeth drifting and secondary occlusal trauma. Appropriate disease classification required clinical judgement and led to the final classification of Stage III, Grade C for both cases. CONCLUSION Patient-based clinical judgement, aiming for long-term preservation of natural dentition, drives the final assignment of staging when the case falls in the "gray zone" that focuses on major differences in Stage III and IV periodontitis.
5PSQ-228 Pharmacist medicines optimisation and error mitigation at paediatric critical care discharge: a human solution to an electronic risk

Background and importance Patients are vulnerable to medication error(s) at discharge from the paediatric intensive care unit (PICU). Clinical outcomes may be compromised if medicines are inappropriately continued, omitted or prescribed incorrectly. There is an additional risk at Evelina London Children’s Hospital (ELCH) as a different prescribing system is used in ward areas (MedChart) and the PICU (eVision). Currently, critical care doctors complete the discharge summary and verbally handover patients to the ward team(s). Ward doctors are responsible for transcribing medicines from eVision to MedChart and ward pharmacists are responsible for completing the medication review. Audits have shown that prospective critical care pharmacist (CCP) step-down checks can lead to mitigation of medicine related transfer of care errors. Aim and objectives Our aim was to assess the current PICU discharge process and review the risk of medication related errors. The objectives were to measure the time taken for medicines to be transcribed from eVision to MedChart; to measure the time taken to complete a discharge medication review; to identify the percentage of transcription errors that occur and classify errors to assess potential risk; and to identify ways to mitigate the risk associated with the current process Material and methods A data collection tool was designed using Microsoft Excel. Prospective data collection took place from 20 July to 7 August 2020. Patients were identified using the ‘discharge’ tool on eVision. 29 PICU discharge transcription charts were reviewed; the number of charts with errors was identified and classified by a PICU pharmacist. Results Average time taken for a doctor to transcribe medicines from eVision to MedChart was 1 hour 50 min. Average time taken for a pharmacist to complete the transcription check on MedChart was 10 hours 54 min. 35% of transcription charts displayed one or more errors. 40% of the identified errors were classified as simple (unlikely to result in harm), and 60% were classified as serious (potential to cause reversible harm). Conclusion and relevance To mitigate the risk associated with the current process, it is proposed that PICU doctors complete the transcription of medicines from eVision to MedChart prior to the patient leaving the PICU, and paediatric CCPs perform discharge medication reviews. By involving the PICU team in the medication discharge process, we aim to improve the quality and safety of step-down prescribing. References and/or acknowledgements Conflict of interest No conflict of interest
Cardiac Arrest in Flight: A Retrospective Chart Review of 92 Patients Transported by a Critical Care Air Medical Service.

Abstract Objective The purpose of this study was to describe the incidence, characteristics, and outcomes of cardiac arrest in the air medical environment so that we can begin to understand predictors of in-flight cardiac arrest and identify opportunities to improve care. Methods This retrospective observational study was undertaken at Airlift Northwest from 2013 to 2017. Descriptive statistics of adult patients with medical and traumatic etiologies of cardiac arrest were analyzed and compared. Results Of the 13,915 adult patients transported during the study period, fewer than 1% (N = 92) had a cardiac arrest during transport. Of those, 42% in the overall cohort had return of spontaneous circulation on arrival at the destination hospital. Medical etiologies of cardiac arrest were more common than traumatic (65% vs. 35%), more likely to have an initial shockable rhythm (30% vs. 3%, P = .004), and more frequently arrived at the receiving hospital with return of spontaneous circulation (57% vs. 31%, P = .03). Rearrest in transport occurred frequently (39%). Most patients were hypotensive before cardiac arrest, and peri-intubation cardiac arrest occurred in 12% of patients. Conclusion Cardiac arrest during air medical transport is a rare event that requires a high level of critical care to treat refractory cardiac arrests, hemodynamic instability, and airway compromise.