cssi/SciSciGPT-SciSciNet huggingface dataset:
Conversion of MoCA to MMSE scores

A method was recently developed to convert Montreal Cognitive Assessment (MoCA) scores to equivalent Mini-Mental State Examination (MMSE) scores [1]. The method was derived from an elderly, primarily Caucasian sample composed of persons with Alzheimer's disease (AD), mild cognitive impairment (MCI), and healthy older controls using the equipercentile equating procedure. We were able to validate this algorithm in a racially diverse sample. We administered to 185 participants from the UT Southwestern Dallas Heart/Brain Aging Study the MoCA and MMSE as part of a larger assessment battery. Our sample included 78 healthy controls, 92 MCI subjects, 15 AD patients, and 9 other dementias. MoCA scores (unadjusted for education) were transformed into equivalent MMSE scores based on the conversion table by Roalf et al. [1]. The intraclass correlation (ICC) between equivalent MMSE scores and MMSE scores was examined. Equivalent MMSE scores derived from the MoCA were highly similar to actual MMSE scores. Equivalent MMSE scores and actual MMSE scores had an ICC coefficient of 0.85 (P < .001). The ICC coefficient remained high among homogeneous gender and ethnic groups (all P < .001) and was highest for females. We concluded that the conversion by Roalf et al. is a valid method to transform MoCA scores to equivalent MMSE scores in this racially diverse sample, which is useful for allowing continuity and comparability of cognitive data in longitudinal studies of MCI or dementia.
Building quality strategy content using the process from national and international quality awards

In pursuit of total quality management (TQM), firms have used quality awards as models for strategic implementation of their quality initiatives. Many researchers have written about the process of implementing TQM, but few have discussed content. Content is defined as the substance of TQM activities that have an impact on firm performance and the ability to compete. This paper offers two propositions for implementing quality models and using them effectively. The first proposition proposes that national and international award criteria are evolving towards content considerations. The second proposition addresses ways in which the various award criteria link content with process in evaluating TQM as a strategic initiative. An analysis is provided of the national and international quality awards of the United States, Europe, Japan, Canada and Australia, which includes the similarities and differences of their underlying quality principles, core values and evaluation criteria. As these awards are updated and...
GRaTIS: Sensing and intelligence for performance in the presence of legacy networks

Recent work has examined techniques to estimate the “best” modulation rate for data networks such as OFDM-based 802.11a/g. Each rate is effective in a range of signal-to-noise ratios (SNRs) but the limited number of practical rates often force the transmitter to “step down” to a lower data rate despite having higher SNR to the receiver. In this paper we describe, evaluate and implement a practical multiuser communication scheme that transmits two packets in the time normally needed to transmit a single packet, increasing aggregate throughput precisely when it is most needed — when the network is busy and suffers from rate unfairness. Because the method transmits a group of packets simultaneously, we call this scheme Group Rate Transmission with Intertwined Symbols, or GRaTIS. This method uses SNR sensing and knowledge about the network to achieve improved performance in the presence of legacy network members.
Georgian Peacekeeping Mission [medical technology applications]

Despite the advances in medical technologies in the West, it is extremely difficult to apply and/or deliver these technologies to conflict zones under the auspices of the UN Peacekeeping Mission. The most difficult challenge is the delivery by UN medical personnel of appropriate technology which is easily transferable and can be operated by trained professionals. Such transference involves overcoming political, religious, ethnic, cultural and bureaucratic obstacles. The UN Observer Mission in the Georgian-Abkhazian conflict, despite excellent military leadership, experienced disastrous medical consequences due to political maneuvering, the lack of quality of key personnel, and clearly defined responsibilities. Local misunderstanding of mission purposes led to unrealistic expectations of available medicine and equipment. Nevertheless, the UN Observer Mission in Georgia helped avert a full-scale armed conflict. Especially in medical emergencies and other life-threatening situations, mission personnel would pull together and overcome personal, political and cultural differences in order to prevent loss of human life.
A mathematical approximation of the angle of closure from retruded contact.

I N THE EXAMINATION of an occlusion, there are two basic mandibular positions which are generally accepted as being essential to diagnosis, namely, the intercuspal position, (ic), and the retruded contact position (rep). 1 6 When ic and rep are not coincident, a deviation of the mandible may be seen in passive closure.* This is mani­ fested by a dislocation of occlusal landmarks and an interference in the hinge axis closure.
Chemical and thermal characteristics of milk-fat fractions isolated by a melt crystallization

Anhydrous milk fat (AMF) was fractionated by a two-stage dry fractionation process to produce three fractions: high melting (HMF), middle melting (MMF), and low melting (LMF). The HMF (m.p. 42°C) exhibited a broad melting range similar to a plastic fat. The MMF (m.p. 33°C) resembled the original AMF (m.p. 31°C), but with slightly higher solid fat content. The LMF (m.p. 16°C) was liquid at ambient temperature. Differences in the thermal properties of these fractions were attributed to the triacylglycerols (TAG) and their fatty acid composition. Saturated TAG with carbon numbers of 36–54 were concentrated in the HMF; whereas unsaturated TAG of carbon number 36–54 predominated in the LMF. Likewise, the long-chain saturated fatty acids were significantly higher and the long-chain unsaturated fatty acids were significantly lower in the HMF fraction. Binary blends of milk-fat fractions with a range of melting profiles were produced by mixing HMF with AMF, MMF, or LMF. Laboratory-prepared fractions were similar to commercially available fractions.
The influence of pore-water chemistry and physiology on the distribution of vesicomyid clams at cold seeps in Monterey Bay: Implications for patterns of chemosynthetic community organization

Analyses of sulfide, methane, oxygen, and CO, in pore-water sampdes from three cold seep sites in Monterey Bay indicate that fluid chemistry is a strong determinant of the distribution of chemolithoautotrophic vesicomyid clams. The distribution of Culyptogena pacijca and Culyptogenu kilmeri were aligned closely with sulfide concentrations at all cold seeps and reflected species-specific capabilities for sulfide binding. Live clams occurred only in sediment where sulfide was detectable. Sulfide was not detected in the absence of vesicomyid clams. The relative abundances of five vesicomyid species varied greatly among seeps. C. kilmeri accounted for 85-99% of all vesicomyids at seeps with high sulfide content, and C. puciJicu dominated (73%) seeps with low sulfide levels. These species were also partially segregated along sulfide gradients from the center to the margin of seeps, analogous to zonation of rocky intertidal communities. We hypothesize that the absence of thiotrophic or methanotrophic mytilid mussels from Monterey Bay cold seeps is related to the lack of physiological specializations for concentrating reduced sulfur compounds or methane and the absence of hypersaline brines that could extend the persistence of methane or sulfide-rich fluids very near the sea floor. Chemosynthetically based communities associated with sulfide and methane seeps are known from various geologic settings along continental margins but remain poorly understood in terms of their geochemistry, biology, and ecology. Seeps in the Pacific Ocean are associated with tectonically induced over-pressure of hemipelagic sediments along subducting (e.g. Oregon, Peru, Japan) and transpressional plate margins (California; Barry et al. 1997), artesian flow at marine exposures of freshwater aquifers (Hovland and Judd 1988), and buried debris flows in axial valleys of submarine canyons (Embley et al. 1990). Most chemosynthetic metazoan symbioses at sea floor seeps depend on sulfur-oxidizing bacterial endosymbionts, especially in the Pacific Ocean where vesicomyid clams and vestimentiferan worms are the dominant metazoan groups. Although seeps in the Atlantic Ocean have a similar fauna, including both vesicomyid clams and vestimentiferan worms, these sites differ from Pa
Potential neural embedding of parental social standing

Socioeconomic disadvantage during childhood and adolescence predicts poor mental and physical health and premature death by major medical diseases in adulthood. However, the neural pathways through which socioeconomic factors may exert a developmental influence on health and longevity remain largely unknown. This fMRI study provides novel evidence of a unique relationship between the perception that one's parents had a relatively low social standinga putative indicator of early socioeconomic disadvantageand greater amygdala reactivity to threatening facial expressions. This relationship was not explained by several possible confounders, including sex, ethnicity, dispositional emotionality, symptoms of depression and anxiety, parental education and participants' perceptions of their own social standing. The amygdala expresses marked developmental plasticity and plays instrumental roles in processing emotional information, regulating emotion-related behaviors and orchestrating biobehavioral stress responses throughout life. Thus, these findings may provide insight into the neurodevelopmental pathways impacting socioeconomic disparities in health.
Hepatocyte growth factor in kidney fibrosis: therapeutic potential and mechanisms of action.

Hepatocyte growth factor (HGF) is a pleiotropic factor that plays an imperative role in tubular repair and regeneration after acute renal injury. Growing evidence indicates that HGF is also an endo...
Comparing Peer Review and Self-Review as Ways to Improve College Students' Writing:

The effect of three approaches to revision instruction on 61 college students’ revision behavior and writing quality was investigated for this article. Students wrote three 5-page papers and received one of three instructional approaches: Formal Peer Review (n D 19), Formal Self-Review (n D 20), or No Formal Review (n D 22). Formal Peer Review students had to outline and critique a peer’s first draft, Formal Self-Review students had to outline and critique their own first draft, and No Formal Review students were simply instructed to revise their own first draft to improve clarity and completeness. No difference in writing quality was detected based on instructional approach. No Formal Review students made more revisions from first to final drafts than students in the other two groups, at both the global (summary) and local (sentence) levels of meaning. Students in the No Formal Review condition had the most positive attitude toward the instruction they received. Results suggest that using peer review in college psychology classes, and a formal approach to reviewing, may not improve the quality of students writing but does affect the timing of students’ revision behavior (before, rather than after, handing in the first draft) and students’ attitudes toward instruction.
Semiconductor nanomembranes: a platform for new properties via strain engineering

New phenomena arise in single-crystal semiconductors when these are fabricated in very thin sheets, with thickness at the nanometer scale. We review recent research on Si and Ge nanomembranes, including the use of elastic strain sharing, layer release, and transfer, that demonstrate new science and enable the fabrication of materials with unique properties. Strain engineering produces new strained forms of Si or Ge not possible in nature, new layered structures, defect-free SiGe sheets, and new electronic band structure and photonic properties. Through-membrane elastic interactions cause the double-sided ordering of epitaxially grown nanostressors on Si nanomembranes, resulting in a spatially and periodically varying strain field in the thin crystalline semiconductor sheet. The inherent influence of strain on the band structure creates band gap modulation, thereby creating effectively a single-element electronic superlattice. Conversely, large-enough externally applied strain can make Ge a direct-band gap semiconductor, giving promise for Group IV element light sources.
An hypothesis on the light requirements for spawning penaeid shrimp, with emphasis on Penaeus setiferus

Wurts, W.A. and Stickney, R.R., 1984. An hypothesis on the light requirements for spawning penaeid shrimp, with emphasis on Penaeus setiferus. Aquaculture, 41: 93-98. Using standard equations, we have concluded that the light intensities which have been used by investigators attempting to induce maturation and spawning are up to 4000 times higher than would occur over the spawning grounds of Penaeus setiferus, a species for which successful controlled spawning has yet to be achieved. We recommend that future attempts at captive maturation and spawning with that species be conducted at light levels of no more than 12 µW cm -2 and that the intensity at which other species of shrimp are matured and spawned be examined relative to natural light levels on their spawning grounds. It is further recommended that the need for light of blue or green color be evaluated for its role as a promotor of maturation and spawning. The intent of these modifications in current spawning procedures is to eliminate the need for eyestalk ablation in captively spawned penaeid shrimp.
Synthesis of Dispersed Y2O3 Nanopowder from Yttrium Stearate

Fine yttrium stearate powder was produced at a relatively low temperature using yttrium nitrate hexahydrate, ammonia and stearic acid as the raw materials. Dispersed Y2O3 nanopowder was synthesized by calcining the yttrium stearate. The formation mechanism of the precursor and the Y2O3 nanopowder was studied by means of XRD, TG-DTA, FT-IR, BET, FE-SEM and HR-TEM. Pure and dispersed Y2O3 nanopowder with an average particle size of 30 nm was produced by calcining the precursor at 600 °C. The particle size increases to about 60 nm with the increase of the calcination temperature to 1000 °C. In the preparation of Y2O3 from yttrium stearate, no water medium is involved, thus capillarity force and bridging of adjacent particles by hydrogen bonds can be avoided, resulting in good dispersion of the particles. The dispersed Y2O3 nanopowder prepared in this work has potential application in phosphors and transparent ceramic materials.
Some fundamental moral issues

From a utilitarian point of view, the most moral act is the one that maximizes the long-term good. Every act has a moral tinge because of the good or evil it brings about, relative to other possibl...
Early Developmental Screening for Children in Foster Care

Limited data exist about the ideal timing of developmental screening for young children entering foster care, and current best practice recommends screening by 1 month into care to prioritize resources for evaluation. Therefore, we aimed to: (1) compare detection rates for potential developmental delay (DD) at foster care entry before and after implementation of a developmental screen and (2) examine accuracy of developmental screening when performed at entry and 1 month into care. Charts of 124 children <6 years evaluated for an initial foster care health assessment (IFCHA) were reviewed to determine baseline detection rates for potential DD. The Parents’ Evaluation of Developmental Status (PEDS) screening tool was then prospectively administered to 167 children <6 years during their IFCHA to determine detection rates. One month following the IFCHA, caregivers were re-contacted, and the screen was re-administered. Accuracy of the initial PEDS screen was compared to the 1 month PEDS screen by calculation of sensitivity and specificity. At baseline, potential DD was detected in 34 % of children at the IFCHA compared to 46 % after implementation of the PEDS (P = 0.041). Compared to the 1 month screen, the early screen had a sensitivity of 75 % and specificity of 88 %. Use of a developmental screening tool at foster care entry increased detection of potential DD, and the results remained consistent with screening 1 month later. These results support use of a developmental screen for children in foster care and suggest that screening be performed as early as possible to expedite necessary evaluations and referrals.
The Clinical Curative Effect of Budesonide Combined with Terbutaline in Treating Pediatric Allergic Bronchitis

Objective To explore the clinical curative effect of budesonide combined with terbutaline on treating pediatric allergic bronchitis. Methods From Apr. 2011 to Apr. 2013,112 cases of children with allergic bronchitis admitted to Nanhai District Maternal and Child Health Care Hospital were randomly divided into two groups. The observation group of 57 cases was treated with budesonide combined with terbutaline.The control group of 55 cases was treated with inhalation of salbutamol. Both groups were given conventional inhibition of inflammatory reaction,symptomatic and supportive treatment,then the clinical efficacy,cough scores and lung function change differences of the two groups were compared. Results Efficacy of the observation group was higher( 89. 27% vs 63. 36%),the difference was statistically significant( P 0. 05); after treatment,cough score of both groups were lower than before treatment,and the lower level of the observation group was betterthan the control group,with statistically significant difference( P 0. 05); after treatment,lung function( FEV1,FVC,MMEF) has increased than before treatment,and the increased level of the observation group better than the control group with statistically significant difference( P 0. 05). Conclusion Budesonide combined with terbutaline treating pediatric allergic bronchitis has significant clinical effect,which is worthy of clinical use.
Proper representations of (multivariate) linear differential systems

Abstract A proper representation of a linear differential system is a representation with no singularity at infinity. It is shown that such a representation always exists. It turns out that for proper representations having minimal number of rows is equivalent to having minimal total row degree. One is led therefore to a natural definition of the notion of minimality. What is remarkable is that a minimal proper representation is uniquely determined up to premultiplication by a unimodular polynomial matrix of special form. This uniqueness result allows, in particular, to introduce important integer invariants.
Shifting Patterns of Interlimb Coordination in Infants' Reaching: A Case Study

Publisher Summary This chapter discusses the shifting patterns of interlimb coordination in development, where periods of predominantly two-handedness in the reach alternate with period of predominantly one-handedness. It presents an analysis of both the reach and the spontaneous movements from which the reach emerges. The periods of two-handed reaching are governed by underlying coordination dynamics that predominantly tend toward interlimb coupling. During times of one-hand use, spontaneous interlimb coordination is much more varied, with different patterns of coupling and uncoupling. The development of reaching involves the coordination and control of the activity of the arm contralateral to the reaching arm. The development of reaching, like the development of walking, must arise from a complex process that involves the coordination of many components together.
Analysis of Performance Resilience for Discrete-Time Systems With Both Multiplicative and Additive Control Gain Perturbations

In this work, a procedure is presented for performance analysis of the resilience property of discrete-time systems with perturbed controller and observer gains. The resilience property is defined in terms of both multiplicative and additive perturbations on the gains so that the closed loop eigenvalues do not leave a specified region in the complex plane. In this work, this region is chosen as a disk in the unit circle. Maximum gain perturbation bounds can be obtained based on the designer’s choices of controller eigenvalue region. The linear matrix inequality technique is used throughout the analysis process. Illustrative examples are included to demonstrate the effectiveness of the proposed methodology. The observer counterpart of the results is also provided in an appendix.Copyright © 2016 by ASME
Ketorolac tromethamine LS 0.4% versus nepafenac 0.1% in patients having cataract surgery. Prospective randomized double-masked clinical trial

Purpose To compare the clinical, subjective, and objective outcomes of the use of 2 topical nonsteroidal antiinflammatory drugs—ketorolac tromethamine LS 0.4% (Acular) and nepafenac 0.1% (Nevanac)—in patients having cataract surgery. Setting Single-center private practice, Las Vegas, Nevada, USA. Methods One hundred eighty-three patients (193 eyes) with visually significant cataract were recruited for the study. Consenting patients were randomized to a standard regimen of Acular, gatifloxacin 0.3% (Zymar), and prednisolone acetate 1% (Pred Forte) (ketorolac group) or Nevanac, moxifloxacin hydrochloride 0.5% (Vigamox), and prednisolone acetate (Econopred) (nepafenac group). Analysis included subjective complaints (burning, itching, foreign-body sensation, pain level after surgery) and objective findings (visual function, degree of inflammation in the anterior segment, complications). Results The ketorolac group consisted of 94 patients (100 eyes) and the nepafenac group, 89 patients (93 eyes). The between-group differences in visual outcomes and anterior chamber inflammation were not statistically significant (mean P = .33). There was a higher incidence of posterior capsule opacification in the nepafenac group ( P = 0.019). Patient satisfaction, patient compliance, and postoperative pain control were statistically significantly better in the ketorolac group ( P = .022, P = .023, and P = .025, respectively). Conclusion Ketorolac tromethamine was statistically significantly better than nepafenac in terms of patient satisfaction, compliance, and postoperative pain control.
Relationship between family history of alcohol addiction, parents’ education level, and smartphone problem use scale scores

Background and aimsSmartphones are ubiquitous. As smartphones increased in popularity, researchers realized that people were becoming dependent on their smartphones. The purpose here was to provide a better understanding of the factors related to problematic smartphone use (PSPU).Methods The participants were 100 undergraduates (25 males, 75 females) whose ages ranged from 18 to 23 (mean age = 20 years). The participants completed questionnaires to assess gender, ethnicity, year in college, father’s education level, mother’s education level, family income, age, family history of alcoholism, and PSPU. The Family Tree Questionnaire assessed family history of alcoholism. The Mobile Phone Problem Use Scale (MPPUS) and the Adapted Cell Phone Addiction Test (ACPAT) were used to determine the degree of PSPU. Whereas the MPPUS measures tolerance, escape from other problems, withdrawal, craving, and negative life consequences, the ACPAT measures preoccupation (salience), excessive use, neglecting work, anticipatio...
Impact of a Dedicated Research Rotation during Ophthalmology Residency.

Background The Accreditation Council for Graduate Medical Education (ACGME) requires that ophthalmology residents participate in scholarly activity during residency. However, residents lack protected time for research. Objective This article aims to determine the impact of a dedicated research rotation on scholarly productivity and research experience during residency. Methods This cohort study compared two groups of ophthalmology residents. Residents who graduated between 2004 and 2009 did not have dedicated research time and served as control residents (CR), while residents who graduated between 2010 and 2015 had a dedicated research rotation and served as the intervention group (research residents, RR). Primary outcomes included publications and presentations recorded over a 4-year period, spanning the 3 years of residency and the first year after graduation. These were analyzed by linear regression and t -tests. Residents also took surveys regarding research experience and chi-squared tests and logistic regression were used to compare these results. Results The RR had 0.97 more publications and 1.3 more presentations compared with the CR after adjusting for PhD status, pre-residency publications and presentations, age at graduation, gender, and race ( p = 0.09 and p = 0.02, respectively). RR had higher odds of reporting adequate time to complete research (odds ratio [OR] = 13.11, 95% confidence interval [CI]: 3.58–48.03, p p = 0.002). Conclusion Residents with a research rotation had more time to complete research, were more satisfied with their research experience, and generated more publications and presentations compared with residents without the research rotation. A research rotation can help meet ACGME requirements and help residents achieve greater scholarly activity.
Effects of exposure to environmental groups on student awareness of environmental issues and their desire to be locally involved

This study investigated changes in high school students' awareness of environmental issues and their intent to be involved with local environmental groups after attendance at an environmental fair ...
2500-Year Paleotempestological Record of Intense Storms for the Northern Gulf of Mexico, United States

Abstract The northern Gulf of Mexico has been devastated by recent intense storms. Camille (1969) and Katrina (2005) are two notable hurricanes that made landfall in nearly the same location in Mississippi. Fully understanding the risks and processes associated with hurricane impacts are impeded by a short and fragmented instrumental record, however. Paleotempestology has the potential to employ modern analogues from intense storms in this region to extend the hurricane record beyond pre-observational time. Existing empirically-based models can back-calculate surge heights over coastal systems as a function of transport distance, particle settling velocity, and gravitational acceleration. We collected sediment cores in a pond (3) and adjacent beach (1) in Hancock County, Mississippi. Grain-size, loss-on-ignition, and microfossil analyses were conducted on cores in the context of a Bayesian statistical age model using 137Cs and 14C dating. Using Hurricane Camille to calibrate the archive, similar coarse-grained deposits were identified, and inverse sediment transport models calculated paleosurge intensities similar in magnitude to Camille over the 2500-yr record. Our multi-millennial annual average landfall probability (0.48%) closely matches previously published studies from the Gulf of Mexico, indicating that intense hurricanes have not varied over these timescales. Over centennial timescales, active intervals occurred between 900 to 600 and 2200 to 1900 yr BP, with relative quiescence between 1900 to 900 yr BP. Comparisons with other published sites support the notion that southerly shifts in the Loop Current may be responsible for the decline in activity around 600 yr BP.
Simulation-Based Learning Improves Anesthesiology Resident Self-Efficacy in Critical Skills: a Flipped Classroom Approach

We implemented a flipped classroom curriculum for our institution’s resident physicians entering their internship year. This curriculum included instructional videos on ACLS, supplemental oxygen delivery, trans-thoracic echocardiography, and line placement, followed by a 3-day simulation-based curriculum. Overall self-efficacy of interns increased following the curriculum. This increased self-efficacy, particularly in procedural ability, was similar to that of PGY-2 residents who had 1 year of experience. Our work suggests that a flipped classroom/simulation-based curriculum for interns can effectively teach a clinical skill set in a short period, yielding self-efficacy in implementing that skill set, particularly in procedural ability, comparable to that after 1 year of residency.
Study of Micro Ultrasonic Machining of CFRP/Ti Stacks

Carbon fiber reinforced plastic (CFRP) composite is one of the most sought after material owing to its superior physical and mechanical properties such as high-durability and high strength-to-weight ratio. CFRP composites are often used by stacking up with titanium (Ti) to form multi-layered material stacks for applications involving extreme mechanical loads. However, machining of CFRP/Ti multi-stacks is quite complex and challenging task since both materials are difficult-to-machine materials and show completely different machinability properties. The challenge is further escalated when there is a need to machine CFRP/Ti stacks at micron level. Several problems arise during the machining process due to the non-homogeneous structure, anisotropic and abrasive properties of composite. Traditional methods of micromachining the CFRP/Ti stacks results in several issues including high cutting force and torque and high tool wear, composite delamination, large groove depth in composite, and poor surface quality. Ultrasonic machining (USM) process has been successfully used to machine titanium, CFRP and CFRP/Ti stack at macro scale. Micro Ultrasonic machining is a downsized version of macro ultrasonic machining process that is developed to machine hard and brittle materials. This research explores the possibility of using Micro USM process to conduct micromachining of CFRP/Ti multi stacks. The effect of various process parameters including abrasive grit size, tool material and type on the material removal process is studied. The study found that micro ultrasonic machining process is capable of successfully micromachining CFRP/Ti stacks with zero CFRP delamination, minimal variation in CFRP and Ti hole sizes and longer tool life. Further, a three-dimensional finite element simulation study is performed on micro ultrasonic machining of CFRP/Ti stacks. The simulation results revealed that the workpiece is not subject to any significant normal stresses during the machining process, while variations in shear stresses is seen on the inside surfaces of the machined cavities.Copyright © 2017 by ASME
Breastfeeding Trends Among Very Low Birth Weight, Low Birth Weight, and Normal Birth Weight Infants

Objective To examine the change in breastfeeding behaviors over time, among low birth weight (LBW), very low birth weight (VLBW), and normal birth weight (NBW) infants using nationally representative US data. Study design Univariate statistics and bivariate logistic models were examined using the Early Child Longitudinal Study—Birth Cohort (2001) and National Study of Children's Health (2007 and 2011/2012). Results Breastfeeding behaviors improved for infants of all birth weights from 2007 to 2011/2012. In 2011/2012, a higher percentage of VLBW infants were ever breastfed compared with LBW and NBW infants. In 2011/2012, LBW infants had a 28% lower odds (95% CI, 0.57-0.92) of ever breastfeeding and a 52% lower odds (95% CI, 0.38-0.61) of breastfeeding for ≥6 months compared with NBW infants. Among black infants, a larger percentage of VLBW infants were breastfed for ≥6 months (26.2%) compared with LBW infants (14.9%). Conclusions Breastfeeding rates for VLBW and NBW infants have improved over time. Both VLBW and NBW infants are close to meeting the Healthy People 2020 ever breastfeeding goal of 81.9%. LBW infants are farther from this goal than VLBW infants. The results suggest a need for policies that encourage breastfeeding specifically among LBW infants.
An autonomic software architecture for distributed applications

Autonomic computing is a grand challenge in computing that aims to produce software that has the properties of self-configuration, self-healing, self-optimization and self-protection. Adding such autonomic properties into existing applications is immensely useful for redeploying them in an environment other than they were developed for. Such transformed applications can be redeployed in different dynamic environments without the user making changes to the application. However, creating such autonomic software entities is a significant challenge not only because of the amount of code transformation required but also for the additional programming needed for such conversion. This thesis presents techniques for injecting autonomic primitives into existing user code by statically analyzing the code and partitioning it to manageable autonomic components. Experiments show that such code transformations are challenging, however they are worthwhile in order to provide transparent autonomic behavior. Software architecture to provide such autonomic computing support is presented and evaluated to determine its suitability for a fully fledged autonomic computing system. The presented architecture is a novel peer-to-peer distributed object-based management automation architecture. In this model, independent or communicating objects are treated as managed elements in the geographically distributed autonomic elements. The presented organization offers significant advantages over a traditional clientserver organization by permitting the incorporation of self-management properties into each of the distributed nodes and making each of the Autonomic Elements in the distributed environment identical in terms of managerial capacity. The unification of traditional client-server roles allows management functions to be distributed across different elements in the system, allowing autonomous behavior of the whole system. This thesis also presents a self regulating design of an autonomic element in a distributed object environment. Architectural choices have a profound effect on the capabilities of any autonomic system and affect many of the design decisions during its implementation. The goal of this architectural design is to provide an easy to program autonomic element which can be implemented in most domains with minor modifications. Profiling and experimentation with this design shows that it is lightweight and perform smoothly without causing extensive overhead.
19 – Processing of carbon nanotubes and carbon nanotube based nanocomposites

: With the continuing developments in materials synthesis and characterization at the nanoscale the potential of true materials tailoring has been enhanced substantially. In general this class of materials involves structures that have at least one dimension at the nanometer scale (usually taken to be up to 100 nanometers). The utilization of these fibers in polymer composites not only enables the development of uniquely created structures but also provides a means for the development of unique properties and functionalities at levels not possible with conventional fiber reinforced composites. It is the goal of this chapter to introduce the advances in CNT nanocomposite research with specific emphasis on processing routes used to disperse, align and fabricate carbon nanotube reinforced polymer nanocomposites for enhanced physical and mechanical properties. Acknowledging that the potential for CNTs as reinforcement and conductive media has not yet been fully realized, a discussion on future trends is also given.
Validation of the two-parameter fracture criterion for various crack configurations made of 2014-T6 aluminum alloy using finite-element fracture simulations – Part 2 TL-Orientation

Abstract In the present paper, the two-parameter-fracture-criterion (TPFC) validity and transferability are analysed using two-dimensional (2D) elastic-plastic finite-element fracture simulations with the critical crack-tip-opening-angle (CTOA) fracture criterion and plane-strain-core concept. Fracture simulations were performed on three crack configurations: (1) middle-crack-tension, M(T), (2) single-edge-crack-tension, SE(T), and (3) single-edge crack-bend, SE(B), specimens to predict failure loads and moments. They were made of 2014-T6 (TL) aluminum alloy. Fracture test data from Orange (NASA) were only available on M(T) specimens (one-half width, w = 38–152 mm), which were all tested at cryogenic (−200 °C) temperature. The critical crack-tip-opening-angle (CTOA) and a plane-strain-core height, hc, were selected to match the failure loads on the M(T) specimens. Fracture test data on the M(T) specimens were also used to determine the two fracture parameters (KF and m). All crack configurations were analysed over a very wide range of widths (w = 19–610 mm) and initial crack-length-to-width (ci/w) ratios ranged from 0.05–0.95. The TPFC was shown to fit the M(T) test data (±5%) and the simulated fracture data fairly well (within 6.5%) for all crack configurations for net-section stresses (Sn) less than the material proportional limit (σpl σ ). For M(T) specimens, a simple approximation was shown to work well for Sn > σpl. Further study is needed for Sn > σpl, for the SE(T) and SE(B) specimens.
Non-Volatile Memory Database Management Systems

This book explores the implications of non-volatile memory (NVM) for database management systems (DBMSs). The advent of NVM will fundamentally change the dichotomy between volatile memory and durable storage in DBMSs. These new NVM devices are almost as fast as volatile memory, but all writes to them are persistent even after power loss. Existing DBMSs are unable to take full advantage of this technology because their internal architectures are predicated on the assumption that memory is volatile. With NVM, many of the components of legacy DBMSs are unnecessary and will degrade the performance of data-intensive applications. We present the design and implementation of DBMS architectures that are explicitly tailored for NVM. The book focuses on three aspects of a DBMS: (1) logging and recovery, (2) storage and buffer management, and (3) indexing. First, we present a logging and recovery protocol that enables the DBMS to support near-instantaneous recovery. Second, we propose a storage engine architecture and buffer management policy that leverages the durability and byte-addressability properties of NVM to reduce data duplication and data migration. Third, the book presents the design of a range index tailored for NVM that is latch-free yet simple to implement. All together, the work described in this book illustrates that rethinking the fundamental algorithms and data structures employed in a DBMS for NVM improves performance and availability, reduces operational cost, and simplifies software development.
What does a pharmacist do? A time and motion study

Abstract Background Pharmacists work in many different settings and have various responsibilities. However, pharmacists are expensive and need to be used efficiently. Previous studies have shown that prescription preparation, clinician interaction, and medical record evaluation take a large part of a pharmacist's day. Additionally, it is also estimated that almost half of their time is considered “non-value added,” or that their tasks could be performed by a non-pharmacist. Objective To observe pharmacists in multiple practice settings and record their activities to gauge inefficiencies. Methods Time and motion methods were used to observe how pharmacists in retail, clinical, hospital, ambulatory, and academic settings perform daily tasks. Data was collected every 5 min for a total of 18 h from each setting, and sorted into 20 general categories of pharmacists’ tasks. Results Pharmacists spend more time verifying prescriptions than any other activity, accounting for 31% of their time. Other common activities were patient education, charting, counseling, and chart review. Conclusion Although most of pharmacists' daily activities add value to the healthcare team, there are ways to use their time more efficiently. Along with delegating tasks to other pharmacy personnel, new initiatives designed to help pharmacists increase time spent on value-added tasks are recommended.
Light, entrainment and alertness: A case study in offices:

It is well established that light affects both visual and non-visual systems. Laboratory studies have shown that, depending upon the time of exposure, short-wavelength light of sufficient amount an...
Body fat gain and loss differentially influence validity of dual-energy x-ray absorptiometry and multifrequency bioelectrical impedance analysis during simultaneous fat-free mass accretion

The validity of dual-energy x-ray absorptiometry (DXA) and multifrequency bioelectrical impedance analysis (MFBIA) for detecting changes in fat mass (FM), fat-free mass (FFM), and body fat percentage (BF%) was evaluated, as compared to a rapid 4-component (4C) model, in 31 females completing 8 weeks of resistance training. Analyses were performed in all participants (ALL) and in subgroups that gained FFM but lost FM (R subgroup) or gained both FFM and FM (G subgroup). It was hypothesized that methods would comparably detect changes in ALL, but discrepancies would occur in subgroup analysis. Changes in body composition did not significantly differ between 4C, DXA, and MFBIA. Equivalence testing indicated that similar changes were detected by DXA and MFBIA, compared to 4C, for ΔFFM in all analyses and ΔBF% in ALL and R subgroup. ΔFM was equivalent to 4C only in R subgroup for DXA and G subgroup for MFBIA. For ΔFM and ΔBF%, DXA and MFBIA produced similar magnitude errors in ALL. However, DXA exhibited lower error in R subgroup, whereas MFBIA exhibited lower error in G subgroup. For ΔFFM, DXA and MFBIA exhibited relatively similar errors in ALL and R subgroup, although MFBIA displayed proportional bias and weaker correlations with 4C than DXA. In G subgroup, MFBIA exhibited lower errors and a higher correlation with 4C ΔFFM than DXA. Although both DXA and MFBIA may have utility for estimating body composition changes during FFM accretion, DXA may be superior during simultaneous FM loss, whereas MFBIA may produce lower error during simultaneous FM gain.
Dismissal policies for vaccine refusal among US physicians: a literature review

Childhood vaccination is one of the greatest public health achievements of the 20th century, yet increasingly, parents question the safety of and need for vaccines. This has led to increased rates ...
Staffing, Financial, and Administrative Oversight Models and Rates of Injury in Collegiate Athletes

Context Structural features of health care environments are associated with patient health outcomes, but these relationships are not well understood in sports medicine. Objective To evaluate the as...
Pairing two growth-based, high-throughput selections to fine tune conformational dynamics in oxygenase engineering

Cyclohexanone monooxygenases (CHMO) consume molecular oxygen and NADPH to catalyze the valuable oxidation of cyclic ketones. However, CHMO usage is restricted by poor thermostability and stringent specificity for NADPH. Efforts to engineer CHMO have been limited by the sensitivity of the enzyme to perturbations in conformational dynamics and long-range interactions that cannot be predicted. We demonstrate a pair of aerobic, high-throughput growth selection platforms in Escherichia coli for oxygenase evolution, based on NADPH or NADH redox balance. We utilize the NADPH-dependent selection in the directed evolution of thermostable CHMO and discover the variant CHMO GV (A245G-A288V) with a 2.7-fold improvement in residual activity compared to the wild type. Addition of a previously reported mutation resulted in A245G-A288V-T415C which has further improved thermostability. We apply the NADH-dependent selection to alter the cofactor specificity of CHMO to accept NADH, a less expensive cofactor than NADPH. We identified the variant CHMO DTNP (S208D-K326T-K349N-L143P) with a 21-fold cofactor specificity switch from NADPH to NADH compared to the wild type. Molecular modeling indicates that CHMO GV experiences more favorable residue packing and backbone torsions, and CHMO DTNP activity is driven by cooperative fine-tuning of cofactor contacts. Our introduced tools for oxygenase evolution enable the rapid engineering of properties critical to industrial scalability.
Dose optimization of early high-dose valproic acid for neuroprotection in a swine cardiac arrest model.

Abstract Aim High-dose valproic acid (VPA) improves the survival and neurologic outcomes after asphyxial cardiac arrest (CA) in rats. We characterized the pharmacokinetics, pharmacodynamics, and safety of high-dose VPA in a swine CA model to advance clinical translation. Methods After 8 ​min of untreated ventricular fibrillation CA, 20 male Yorkshire swine were resuscitated until return of spontaneous circulation (ROSC). They were block randomized to receive placebo, 75 ​mg/kg, 150 ​mg/kg, or 300 ​mg/kg VPA as 90-min intravenous infusion (n ​= ​5/group) beginning at ROSC. Animals were monitored for 2 additional hours then euthanized. Experimental operators were blinded to treatments. Results The mean(SD) total CA duration was 14.8(1.2) minutes. 300 ​mg/kg VPA animals required more adrenaline to maintain mean arterial pressure ≥80 ​mmHg and had worse lactic acidosis. There was a strong linear correlation between plasma free VPA Cmax and brain total VPA (r2 ​= ​0.9494; p ​ Conclusions Up to 150 ​mg/kg VPA can be safely tolerated as 90-min intravenous infusion in a swine CA model. High-dose VPA induced dose-dependent increases in brain histone H3 and H4 acetylation, which can be predicted by plasma free VPA Cmax as the pharmacodynamics biomarker for VPA target engagement after CA.
Monitoring and Managing Men Following Initial Treatment of Prostate Cancer

Following the initial treatment of prostate cancer, men can be divided into one of three monitoring categories: no evidence of disease, disease status unknown (biochemical recurrence), and evidence of recurrence (measurable disease). Irrespective of initial treatment, monitoring is based on interval measurement of serum prostate-specific antigen (PSA). Multiple options for monitoring these men should be considered based on the patient’s pathology at diagnosis, stage, and primary treatment. Two national guidelines provide evidence-based guidance for the care of these patients. Concern for biochemical recurrence or recurrent disease is based on a rise, and ultimately, the doubling time of PSA. Additional diagnostic testing is then obtained to differentiate biochemical recurrence versus measurable disease. Chest imaging, computerized tomography (CT) or magnetic resonance imaging (MRI), and bone imaging are used to characterize a metastatic disease. If imaging studies fail to identify metastases, positron emission tomography (PET)-CT or PET-MRI can be considered. When imaging identifies probable metastatic disease, then histologic confirmation is obtained to guide additional oncologic treatment. The particular pathway and its timing are influenced by multiple factors such as risk level, PSA doubling time, age, and general health. Throughout this process, shared decision-making guides the individual pathway and timing of ongoing monitoring, additional diagnostic evaluation for metastatic disease, and treatment.