cssi/SciSciGPT-SciSciNet huggingface dataset:
Systems consultation: protocol for a novel implementation strategy designed to promote evidence-based practice in primary care

Adoption of evidence-based practices takes place at a glacial place in healthcare. This research will pilot test an innovative implementation strategy – systems consultation –intended to speed the adoption of evidence-based practice in primary care. The strategy is based on tenets of systems engineering and has been extensively tested in addiction treatment. Three innovations have been included in the strategy – translation of a clinical practice guideline into a checklist-based implementation guide, the use of physician peer coaches (‘systems consultants’) to help clinics implement the guide, and a focus on reducing variation in practices across prescribers and clinics. The implementation strategy will be applied to improving opioid prescribing practices in primary care, which may help ultimately mitigate the increasing prevalence of opioid abuse and addiction. The pilot test will compare four intervention clinics to four control clinics in a matched-pairs design. A leading clinical guideline for opioid prescribing has been translated into a checklist-based implementation guide in a systematic process that involved experts who wrote the guideline in consultation with implementation experts and primary care physicians. Two physicians with expertise in family and addiction medicine are serving as the systems consultants. Each systems consultant will guide two intervention clinics, using two site visits and follow-up communication by phone and email, to implement the translated guideline. Mixed methods will be used to test the feasibility, acceptability, and preliminary effectiveness of the implementation strategy in an evaluation that meets standards for ‘fully developed use’ of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). The clinic will be the primary unit of analysis. The systems consultation implementation strategy is intended to generalize to the adoption of other clinical guidelines. This pilot test is intended to prepare for a large randomized clinical trial that will test the strategy against other implementation strategies, such as audit/feedback and academic detailing, used to close the gap between knowledge and practice. The systems consultation approach has the potential to shorten the famously long time it takes to implement evidence-based practices and clinical guidelines in healthcare.
Genomic patterns of geographic differentiation in Drosophila simulans

Geographic patterns of genetic differentiation have long been used to understand population history and to learn about the biological mechanisms of adaptation. Here we present an examination of genomic patterns of differentiation between northern and southern populations of Australian and North American Drosophila simulans, with an emphasis on characterizing signals of parallel differentiation. We report on the genomic scale of differentiation and functional enrichment of outlier SNPs. While, overall, signals of shared differentiation are modest, we find the strongest support for parallel differentiation in genomic regions that are associated with regulation. Comparisons to Drosophila melanogaster yield potential candidate genes involved in local adaptation in both species, providing insight into common selective pressures and responses. In contrast to D. melanogaster, in D. simulans we observe patterns of variation that are inconsistent with a model of temperate adaptation out of a tropical ancestral range, highlighting potential differences in demographic and colonization histories of this cosmopolitan species pair.
Different Clinical Implications of Substantia Nigra R2* and Diffusion Tenser Imaging Changes in Parkinson's Disease (P03.121)

Objective: To investigate the clinical implications of MRI R2* relaxation rate and DTI fractional anisotropy (FA) in different areas of the SN in PD. Background R2* and FA values may reflect different pathophysiologies in the SN of Parkinson9s disease (PD) patients. The majority (>80%) of PD-related cell death is known to occur prior to the diagnosis and affect more ventral than dorsal parts of SN. Design/Methods: High resolution MRI (T2*, DTI) were obtained from 28 Controls and 40 PD subjects with 15 early (disease duration≤1 year), 14 medium (disease duration 2-5 years), and 11 later (disease duration>5 years) stage disease. FA and R2* in dorsal and ventral SN of all and each stage of PD subjects were compared to those of Controls, and correlated with clinical measures (UPDRS-III, akinetic/rigidity, and tremor scores “off” drug, disease duration, and levodopa equivalent dosage), after controlling for age and gender. Results: Compared to Controls, PD subjects demonstrated significantly increased R2* and reduced FA in the SN overall. R2* changes presented a similar pattern in both ventral and dorsal SN and correlated with all clinical measures except tremor scores. FA changes in ventral and dorsal SN were not correlated with clinical measurements, except for tremor score in dorsal SN. The pattern of change in the two regions, however, was different. Ventral SN changes occurred early and persisted through later stages of PD, whereas FA changes in dorsal SN seemed not to be present early in disease but became significant in later stages. Conclusions: The differential clinical correlation of R2* and FA measures in the SN supports the notion that FA changes in ventral SN at earlier stages may reflect existing PD-related cell death, but R2* may be gauging the changes of progression that are either pathoetiological or compensative related. Further studies are warranted. Supported by: NS060722 (GD, MML, QXY, and XH), and the HMC GCRC (NIH M01RR10732) and GCRC Construction Grant (C06RR016499). Disclosure: Dr. Du has nothing to disclose. Dr. Lewis has nothing to disclose. Dr. Sen has nothing to disclose. Dr. Shaffer has nothing to disclose. Dr. Styner has nothing to disclose. Dr. Wang has nothing to disclose. Dr. Yang has nothing to disclose. Dr. Huang has nothing to disclose.
Two Cheers for Paperwork: The Value and Burden of Federal Reporting

In principle, reporting by state and local governments to the federal government is essential to the design and implementation of national policy. In practice, reporting often engenders resentment offederal intrusion and is often dismissed as a waste of state and local resources. Is reporting useless? Does it strengthen the federal government at the expense of state and local governments? We asked federal, state, local, and site officials about the value and burden offive specific reporting systems in elementary and secondary education. Common assumptions about reporting did not correspond to respondent reactions. Both value and burden cascade through the intergovernmental system, reaching policymakers in all governments. Although critics seldom discriminate between types of reporting, we found that reporting designed to improve compliance with federal standards evoked different judgments of value and burden than reporting designed for assistance. These results suggest some new approaches to federalpolicy governing the collection of information and to the design of individual reporting systems.
BRCA1 mutations in women attending clinics that evaluate the risk of breast cancer.

Background To define the incidence of BRCA1 mutations among patients seen in clinics that evaluate the risk of breast cancer, we analyzed DNA samples from women seen in this setting and constructed probability tables to provide estimates of the likelihood of finding a BRCA1 mutation in individual families. Methods Clinical information, family histories, and blood for DNA analysis were obtained from 263 women with breast cancer. Conformation-sensitive gel electrophoresis and DNA sequencing were used to identify BRCA1 mutations. Results BRCA1 mutations were identified in 16 percent of women with a family history of breast cancer. Only 7 percent of women from families with a history of breast cancer but not ovarian cancer had BRCA1 mutations. The rates were higher among women from families with a history of both breast and ovarian cancer. Among family members, an average age of less than 55 years at the diagnosis of breast cancer, the presence of ovarian cancer, the presence of breast and ovarian cancer in t...
Free thyroxine index in maternal and cord sera: coefficients of variation evaluated by the method of differences of duplicates.

Evaluation of thyroid function in the newborn may be critical for patient care. In the newborn, the normal ranges for protein-bound iodine, butanol-extractable iodine, thyroxine, triiodothyronine uptake and free thyroxine as reported in the literature have shown diagnostic discrepancies. The free thyroxine index, an estimate of the free thyroxine, was determined on paired sera from 30 healthy newborn infants and their mothers. The values of the free thyroxine indexes in infants and mothers were within the adult normal range for our laboratory.
Bi-Monthly Physiological Climates and Annual Stresses and Regimes of Africa

An attempt has been made to analyze the areal distribution of climatic features which influence man's comfort in Africa. Monthly and annual indices were applied to about 800 stations. According to the findings the year-round mildest regions occur in the eastern highlands and along cool-current coasts while greatest heat stress is experienced along the Red Sea, Gulf of Aden and interior Somalia.
Initial Evaluation and Triage of the Injured Patient: Mechanisms of Injury and Triggers for Operating Room Versus Emergency Department Stabilization

Trauma anesthesiologists are uniquely juxtaposed with the multidisciplinary trauma team, serving both an administrative role in preparing the operating room (OR) and allocating resources for resuscitation, and a direct patient care role, providing definitive airway management and advanced resuscitation. Trauma anesthesiologists must have an intimate understanding regarding mechanisms of injury, appropriate diagnostic modalities, and current practices regarding OR versus emergency department or radiology suite (IR) resuscitation. In this review, current practices regarding assessment and triage, mechanisms of injury, and the concepts of surgical, orthopedic, and radiology “damage control” approaches to the severely injured trauma patient are discussed.
Scalable Isolation of Mammalian Mitochondria for Nucleic Acid and Nucleoid Analysis

Isolation of mitochondria from cultured cells and animal tissues for analysis of nucleic acids and bona fide mitochondrial nucleic acid binding proteins and enzymes is complicated by contamination with cellular nucleic acids and their adherent proteins. Protocols presented here allow for quick isolation of mitochondria from a small number of cells and for preparation of highly purified mitochondria from a larger number of cells using nuclease treatment and high salt washing of mitochondria to reduce contamination. We further describe a method for the isolation of mitochondrial DNA-protein complexes known as nucleoids from these highly purified mitochondria using a combination of glycerol gradient sedimentation followed by isopycnic centrifugation in a non-ionic iodixanol gradient.
Impact of Image Orientation on Measurements of Thyroid Nodule Stiffness Using Shear Wave Elastography

Objectives To assess the effect of orientation on the stiffness measurement by shear wave elastography (SWE) within a thyroid nodule. Methods Forty-five patients with 50 thyroid nodules were enrolled in this study. After a short sonographic examination, SWE images were acquired in transverse and longitudinal orientations. Multiple elastograms of each nodule were obtained in both orientations. Mean and maximum stiffness values were recorded from each region of interest. The overall mean and maximum stiffness values of each nodule were calculated for both orientations separately. The concordance correlation coefficient was used to assess overall agreement between measurements. A receiver operating characteristic curve analysis was conducted to assess diagnostic performance for benign versus malignant nodules. Results The 45 patients included 6 men and 39 women (mean age, 53 years; range, 23–84 years). The mean stiffness values ± SD were 19.1 ± 18.4 and 20.9 ± 21.5 kPa for transverse and longitudinal measurements, respectively, with a small overall bias between the orientations (1.8 kPa; P = .09). Overall agreement was good (concordance correlation coefficient, 0.93) although moderated somewhat after the stiffness values were log transformed to reduce skewness (concordance correlation coefficient, 0.76). Of the 50 nodules, 6 were classified as malignant. The area under the curve based on the mean stiffness value from longitudinal images tended to be better than for transverse images, but the difference was not statistically significant (0.93 versus 0.83; P = .17). Conclusions Our study has shown that good diagnostic performance can be achieved by using SWE in longitudinal and transverse orientations. Moderate to good agreement in mean and maximum stiffness values for both orientations was observed, with only a small bias. Diagnostic performance for benign and malignant nodules was similar. The similar performance of both orientations gives flexibility in imaging patients with anatomic or physical limitations.
German Literature as World Literature

Issues of literary globalization are en vogue. The German Studies Association at its annual conference in 2012 held a roundtable discussion on “World Literature” and a seminar on “Transnationalism”...
Examination of the overlap between DSM-111-R overanxious disorder and DSM-IV generalized anxiety disorder in childhood

OF THE THESIS EXAMINATION OF THE OVERLAP BETWEEN DSM-III-R OVERANXIOUS DISORDER AND DSM-IV GENERALIZED ANXIETY DISORDER IN CHILDHOOD by Candice A. Alfano Florida International University, 2000
Developing a predictive model for cancer clinical trial accrual.

6557 Background: With increasing cost to conduct clinical trials, it is imperative to select trials rationally for local activation. We sought to create a predictive model with an outcome of antici...
Information, Representation, Biology

Biosemiotics contains at its core fundamental issues of naturalism: are normative properties, such as meaning, referent, and others, part of the natural world, or are they part of a second, intentional and normative, metaphysical realm — one that might be analogically applied to natural phenomena, such as within biological cells — but a realm that nevertheless remains metaphysically distinct? Such issues are manifestations of a fundamental metaphysical split between a “natural” realm and a realm of normativity and intentionality. This problematic metaphysical split derives from conceptual problems originating with the Pre-Socratics; transcending that split requires correcting those problems. In particular, transcending that split requires a model of metaphysical emergence, and, in particular, normative emergence. This paper will limn that argument regarding metaphysical emergence, but focus most strongly on an overview of a model of normative, representational emergence that overcomes that metaphysical diremption.
Using wheel availability to shape running behavior of the rat towards improved behavioral and neurobiological outcomes.

Abstract Background Though voluntary wheel running (VWR) has been used extensively to induce changes in both behavior and biology, little attention has been given to the way in which different variables influence VWR. This lack of understanding has led to an inability to utilize this behavior to its full potential, possibly blunting its effects on the endpoints of interest. New method We tested how running experience, sex, gonadal hormones, and wheel apparatus influence VWR in a range of wheel access “doses”. Results VWR increases over several weeks, with females eventually running 1.5 times farther and faster than males. Limiting wheel access can be used as a tool to motivate subjects to run but restricts maximal running speeds attained by the rodents. Additionally, circulating gonadal hormones regulate wheel running behavior, but are not the sole basis of sex differences in running. Comparison with Existing Method(s) Limitations from previous studies include the predominate use of males, emphasis on distance run, variable amounts of wheel availability, variable light-dark cycles, and possible food and/or water deprivation. We designed a comprehensive set of experiments to address these inconsistencies, providing data regarding the “microfeatures” of running, including distance run, time spent running, running rate, bouting behavior, and daily running patterns. Conclusions By systematically altering wheel access, VWR behavior can be finely tuned – a feature that we hypothesize is due to its positive incentive salience. We demonstrate how to maximize VWR, which will allow investigators to optimize exercise-induced changes in their behavioral and/or biological endpoints of interest.
Protein Phosphatase 2A and Its Methylation Modulating Enzymes LCMT-1 and PME-1 Are Dysregulated in Tauopathies of Progressive Supranuclear Palsy and Alzheimer Disease.

Hyperphosphorylated tau aggregates are characteristic of tauopathies including progressive supranuclear palsy (PSP) and Alzheimer disease (AD), but factors contributing to pathologic tau phosphorylation are not well understood. Here, we studied the regulation of the major tau phosphatase, the heterotrimeric AB55αC protein phosphatase 2 A (PP2A), in PSP and AD. The assembly and activity of this PP2A isoform are regulated by reversible carboxyl methylation of its catalytic C subunit, while the B subunit confers substrate specificity. We sought to address whether the decreases in PP2A methylation and its methylating enzyme, leucine carboxyl methyltransferase (LCMT-1), which are reported in AD, relate to tau pathology or to concomitant amyloid pathology by comparing them in the relatively pure tauopathy PSP. Immunohistochemical analysis of frontal cortices showed that methyl-PP2A is reduced while demethyl-PP2A is increased, with no changes in total PP2A or B55α subunit, resulting in a reduction in the methyl/demethyl PP2A ratio of 63% in PSP and 75% in AD compared to controls. Similarly, Western blot analyses showed a decrease of methyl-PP2A and an increase of demethyl-PP2A with a concomitant reduction in the methyl/demethyl PP2A ratio in both PSP (74%) and AD (76%) brains. This was associated with a decrease in LCMT-1 and an increase in the demethylating enzyme, protein phosphatase methylesterase (PME-1), in both diseases. These findings suggest that PP2A dysregulation in tauopathies may contribute to the accumulation of hyperphosphorylated tau and to neurodegeneration.
High throughput reaction screening using desorption electrospray ionization mass spectrometry

We report the high throughput analysis of reaction mixture arrays using methods and data handling routines that were originally developed for biological tissue imaging. Desorption electrospray ionization (DESI) mass spectrometry (MS) is applied in a continuous on-line process at rates that approach 104 reactions per h at area densities of up to 1 spot per mm2 (6144 spots per standard microtiter plate) with the sprayer moving at ca. 104 microns per s. Data are analyzed automatically by MS using in-house software to create ion images of selected reagents and products as intensity plots in standard array format. Amine alkylation reactions were used to optimize the system performance on PTFE membrane substrates using methanol as the DESI spray/analysis solvent. Reaction times can be <100 μs when reaction acceleration occurs in microdroplets, enabling the rapid screening of processes like N-alkylation and Suzuki coupling reactions as reported herein. Products and by-products were confirmed by on-line MS/MS upon rescanning of the array.
Efficient frequency domain CNN algorithm

Deep Learning techniques like Convolutional Neural Networks (CNN) are getting popular for image classification with broad usage spanning across automotive, industrial, medicine, robotics etc. Typical CNN network consists of multiple layers of 2D convolutions, non-linearity, spatial pooling and fully connected layer, with 2D convolutions constituting more than 90% of total computations. The Fast Fourier Transform (FFT) based approach for convolution is promising in theory, but not used in practice due to growth in memory sizing of coefficients storage. The paper proposes new frequency domain algorithm which avoids memory size growth compared to traditional FFT based approach for performing 2D convolution. The proposed algorithm performs Fourier Transform (FT) of coefficients On-The-Fly (OTF) instead of offline calculation on PC. The proposed algorithm consists of expands, OTF-FT and pruning blocks that do efficient 2D convolution in the frequency domain. The proposed algorithm is compared with the FFT-based algorithm for the coefficient transformation. As per simulations, assuming typical network configuration parameters, the proposed algorithm is 4–8X faster compared to FFT based approach for the co-efficient transform.
Mean value analysis of closed queueing networks with Erlang service time distributions

The classical mean value analysis approach is extended to single class closed queueing networks containing Erlang service time distributions and FCFS scheduling disciplines. A new formula for the mean residence time of jobs is derived. Each iteration provides self-checks for validity, and is repeated whenever invalid results are detected. On the average, the solutions obtained vary by less than five percent from their respective simulation results.
Superoxide Dismutase and Cancer Therapy

The primary superoxide scavenger, SOD, has become an important potential therapeutic modality for cancer treatment in view of the link between reactive oxygen species (ROS) and carcinogenesis. Ironically, these same ROS also play a critical role in anticancer therapies that depend on ROS generation for their action rendering the use of SOD, in these settings, as a potential interfering factor that could decrease therapeutic efficacy. This complicating situation arises since ROS are well recognized for playing a dual role as both beneficial signaling molecules as well as deleterious damaging species in biological systems. A growing body of evidence has shown that ROS act as secondary messengers in intracellular signaling cascades, which stimulate and support the oncogenic phenotype of cancer cells. On the other hand, ROS also function as antitumorigenic species since they can induce cellular senescence and death. Therefore, the appropriate application of these antioxidant enzymes is a critical consideration in designing proper strategies for both prevention and treatment of malignant disorders. This chapter reviews evidence that suggests SOD as an emerging therapeutic agent as well as a target for cancer treatment. A discussion is also devoted to the practical challenges that limit the use of SOD manipulation as an anticancer approach.
Chemistry and Properties of Medium-Mn Two-Stage TRIP Steels

Eight medium manganese steels ranging from 10 to 15 wt pct Mn have been produced with varying levels of aluminum, silicon, and carbon to create steels with varying TRIP (transformation-induced plasticity) character. Alloy chemistries were formulated to produce a range of intrinsic stacking fault energies (ISFE) from − 2.2 to 13.3 mJ/m2 when calculated at room temperature for an austenitic microstructure having the nominal alloy composition. Two-stage TRIP behavior was documented when the ISFE of the γ-austenite phase was 10.5 mJ/m2 or less, whereas an ISFE of 11.9 mJ/m2 or greater exhibited TWIP (twin-induced plasticity) with single-stage TRIP to form α-martensite. Properties were measured in both hot band (hot rolled) and batch annealed (hot rolled, cold rolled, and annealed) conditions. Hot band properties were influenced by the Si/Al ratio and this dependence was related to incomplete recovery during hot working for alloys with Si/Al ratios greater than one. Batch annealing was conducted at 873 K (600 °C) for 20 hours to produce ultrafine-grained microstructures with mean free slip distances less than 1 μm. Batch-annealed materials were found to exhibit a Hall–Petch dependence of the yield strength upon the mean free slip distance measured in the polyphase microstructure. Ultimate tensile strengths ranged from 1450 to 1060 MPa with total elongations of 27 to 43 pct. Tensile ductility was shown to be proportional to the sum of the products of volume fraction transformed times the volume change associated for each martensitic transformation. An empirical relationship based upon the nominal chemistry was derived for the ultimate tensile strength and elongation to failure for these batch-annealed steels. Two additional alloys were produced based upon the developed understanding of these two-stage TRIP steels and tensile strengths of 1150 MPa with 58 pct total elongation and 1400 MPa and 32 pct ductility were achieved.
Chromatin remodeling controls Kaposi's sarcoma-associated herpesvirus reactivation from latency.

Kaposi’s sarcoma-associated herpesvirus (KSHV) is the etiologic agent of three human malignancies, the endothelial cell cancer Kaposi’s sarcoma, and two B cell cancers, Primary Effusion Lymphoma and multicentric Castleman’s disease. KSHV has latent and lytic phases of the viral life cycle, and while both contribute to viral pathogenesis, lytic proteins contribute to KSHV-mediated oncogenesis. Reactivation from latency is driven by the KSHV lytic gene transactivator RTA, and RTA transcription is controlled by epigenetic modifications. To identify host chromatin-modifying proteins that are involved in the latent to lytic transition, we screened a panel of inhibitors that target epigenetic regulatory proteins for their ability to stimulate KSHV reactivation. We found several novel regulators of viral reactivation: an inhibitor of Bmi1, PTC-209, two additional histone deacetylase inhibitors, Romidepsin and Panobinostat, and the bromodomain inhibitor (+)-JQ1. All of these compounds stimulate lytic gene expression, viral genome replication, and release of infectious virions. Treatment with Romidepsin, Panobinostat, and PTC-209 induces histone modifications at the RTA promoter, and results in nucleosome depletion at this locus. Finally, silencing Bmi1 induces KSHV reactivation, indicating that Bmi1, a member of the Polycomb repressive complex 1, is critical for maintaining KSHV latency.
Impact of Cyclic Citrullinated Peptide Antibody Level on Progression to Rheumatoid Arthritis in Clinically Tested Cyclic Citrullinated Peptide Antibody-Positive Patients Without Rheumatoid Arthritis.

Objective To investigate the risk of progression to rheumatoid arthritis (RA) in patients who were cyclic citrullinated peptide (CCP) antibody positive without RA at initial presentation. Methods We performed a retrospective cohort study of CCP+ individuals seen at a US tertiary care system between 2009 and 2018 who were without RA or other systemic rheumatic disease by medical record review at the time of CCP antibody positivity. Progression to classifiable RA was determined through medical record review. We investigated the risk of progression to RA overall and stratified by CCP antibody level (low: >1 to 2× the upper limit of normal [ULN]; medium: >2 to 3× ULN; high: >3× ULN). Multivariable Cox regression estimated the hazard ratio (HR) and 95% confidence interval (95% CI) for RA by CCP antibody level. Results We identified 340 CCP+ patients who were without RA or other rheumatic disease at baseline. During 1,047 person-years of follow-up, 73 patients (21.5%) developed RA. The risk of progression to RA increased with CCP antibody level, with 46.0% (95% CI 34.7-55.3) of patients with high-level CCP antibodies progressing to RA by 5 years. Compared to low CCP antibody level, medium (HR 3.00 [95% CI 1.32-6.81]) and high (HR 4.83 [95% CI 2.51-9.31]) CCP antibody levels were strongly associated with progression to RA, adjusting for age, sex, body mass index, smoking, family history of RA, and rheumatoid factor level. Conclusion Among CCP+ patients without RA, the risk for progression to RA increased substantially with increasing CCP antibody level. This study provides further support for close monitoring for development of RA among CCP+ patients and identifying strategies to mitigate this risk.
Human neutrophil elastase alters human alpha-thrombin function: limited proteolysis near the gamma-cleavage site results in decreased fibrinogen clotting and platelet-stimulatory activity

During blood coagulation, polymorphonuclear leukocytes release elastase in amounts that can exceed 100 nmol/L. We therefore studied the interaction between human leukocyte elastase and human alpha-thrombin. Elastase cleaved the thrombin B chain (Ala 150-Asn 151) near the gamma-cleavage site, resulting in two fragments held together by noncovalent interactions. The NH2-terminal fragment (FI), mol wt approximately 18,000, was disulfide-linked to the thrombin A chain. The COOH-terminal fragment (FII), mol wt approximately 13,000, contained the active-site serine and formed a covalent bond with antithrombin III. Heparin accelerated proteolysis of alpha-thrombin by elastase. Proteolyzed alpha-thrombin (T theta) retained full amidolytic activity; however, the concentration of T theta causing 50% maximal platelet aggregation and adenosine triphosphate (ATP) release was 7.9 nmol/L (1.1 nmol/L for alpha-thrombin and 220 nmol/L for gamma-thrombin). Fibrinogen clotting activity of T theta and gamma-thrombin was 32% and 1% that of alpha-thrombin, respectively. Elastase released during the coagulation process may modulate thrombin activity. In addition, elastase-modified thrombin may be a useful probe of the structure and function of the gamma-cleavage region.
Participatory Development: A Sustainable Approach for Reducing Inequality and Fighting Poverty? The Example of Disability Policies in Afghanistan

In this chapter, Bakhshi and Trani take discussions of empowerment and participation from a capability perspective further. They argue that despite the well-intended claims of international frameworks and actors, ownership and empowerment have been misused in development practice as well as theory. Development efforts can be criticised for failing to take into consideration the voices of the most vulnerable in given contexts. This is illustrated with reference to the evolution of a disability programme in post-Taliban Afghanistan. The first part of their chapter shows that most development programmes, including the Afghan project, define participation in narrow terms to involve little more than basic service delivery communicated through ‘consultations’ with select local stakeholders. The agency aspect of the capability approach, which has the potential to empower the marginalised and socially excluded, is lost altogether. The second part of their chapter shows how the absence of well-defined principles for participation and effective change in fragile contexts, such as Afghanistan, affects progress towards improving the lives of aid ‘recipients’ and pose serious threats to the sustainability of development projects. The authors advance strong arguments for involving the ‘recipients of aid’ in all phases of development projects and for transferring power to enhance agency.
Design Techniques for Zero Steady-State Output Ripple in Digital Low Dropout Regulators

We present two technology portable design techniques to achieve zero steady-state output voltage ripple in digital LDOs. Traditional digital LDOs have an inherent output voltage ripple due to the limit cycle oscillations at a frequency of F clock /(2×Mode). We use a 4-bit digital LDO as the test vehicle to investigate these two new techniques. The power-switch bank consists of PMOS HVT (high threshold) devices. The first method uses body biasing of the switches via an auxiliary analog loop to minimize the ripple voltage. Effectively, the analog loop enables the power switches to carry the extra ripple current and has little impact on the efficiency. In the second method, zero steady-state ripple is achieved by modulating the gate-driver voltage-swings at the power-switch gate. In both the techniques, when the digital LDO is in steady state, the analog loop only carries the ripple current magnitude. Control from the analog and digital loops are ping-ponged based on load transients. The LDO design handles inputs from 0.5-1.5V and supports a 0.4-1.2V output voltage for a load range of 0.1-to-20mA (200X). The LDO achieves 99.4% current efficiency and near-zero output voltage ripple. The total area of chip is 0.08mm2 in TSMC 65nm CMOS GP.
Impact of knowledge, attitude and perceptions on medication adherence in children with asthma

Introduction: Poor medication adherence is a common cause of persistent poor control in children with asthma. Aim: To assess the impact of knowledge, attitude and perceptions about asthma, on medication adherence in children with asthma. Methods: In this prospective study, children aged 7-18 years with asthma had comprehensive clinical assessment and spirometry. A 31 item questionnaire to assess the knowledge, attitude and perceptions (KAP questionnaire) about asthma was administered. Medication adherence was assessed by a combination of self reporting, pharmacy records review, inhaler check, and tablet counting, as appropriate; and was classified into 3 groups (good, average and poor). Asthma control was assessed as controlled, partly controlled or uncontrolled based on the GINA criteria. Results: 180 children (mean [SD] age=11.4 [2.8] years, 59.4% males) were studied. Adherence was good in 101 (56.1%), average in 56 (31.1%) and poor in 23 (12.8) children. The proportion (mean [95% CI]) of appropriate responses on the KAP questionnaire in those with poor adherence (47.7 [41.2-54.2]%) was significantly lower compared to those with good (57.2 [53.4-60.9]%) and average (52.5 [49.1-55.8]%) adherence (p=0.0433). Asthma control was good in 47.5% with good adherence, compared to 33.8% with average or poor adherence (p=0.0031). Significant bronchodilator reversibility in FEV1 (≥12%) was observed in 23.7% with good adherence, compared to 39.2% with average or poor adherence (p=0.0338). Conclusions: Our data suggest that knowledge, attitudes, and perceptions about asthma affect medication adherence and asthma control. Hence, improving these should be a key focus in the management of asthma.
Using VoiceThread as a discussion platform to enhance student engagement in a hospitality management online course

Abstract Video- and voice-enabled discussion platforms have the potential to increase student engagement, leading to student success. The cloud-based discussion platform, VoiceThread, was used with undergraduate students in an online hospitality facilities management course. The findings revealed that students’ use of the audio function, both for posting their own responses and for listening to others, was a statistically significant predictor of student engagement with their classmates. The results from this mixed mode exploratory study offer theoretical implications for the CoI framework, as well as best practices for instructors interested in using VoiceThread, including discussion design and grading strategies.
Using Novel Biomarkers to Predict Chemo-Induced Cardiovascular Toxicity in Patients with Breast Cancer

Despite improvement in survival in breast cancer patients from advanced therapies, rates of chemotherapy-induced cardiotoxicity manifesting as a decline in left ventricular ejection fraction (LVEF) have offset some of these benefits in patients receiving anthracycline-based chemotherapy followed by trastuzumab. Results suggesting clinical biomarkers predict cardiotoxicity have been inconsistent. Recently, the expression of angiotensin II type 1 receptor (ATR1) and endothelin 1 (ET1) has shown to play a role in breast tumor growth. We sought to evaluate whether the presence of ATR1 and ET1 in breast cancer tissue using immunohistochemistry (IHC) and qRT-PCR can predict chemotherapy-induced cardiotoxicity. We hypothesized that elevated expression of ATR1 and ET1 in tumor tissue is associated with chemotherapy-induced cardiotoxicity (LVEF
Indirect Reciprocity with Contagious Reputation in Large-Scale Small-World Networks

The question of why acts of selflessness occur in a Hobbesian self-help world has fascinated scholars for decades, if not centuries. Utilizing simulations, previous research has shown that altruism can be evolutionarily stable in small-scale societies under a narrow set of circumstances. However, when expanding such models to populations of anything larger than a few hundred people, they generally break down. In this paper, I modify the widely used image-score mechanism to include contagion-based reputation and demonstrate how altruism can survive in populations of up to 20,000. I also find that selflessness strongly depends on network topology - as heavily clustered small-world societies that resemble tight-knit family or friendship structures promote more cooperation than random networks where connections are more superficial.
Addressing the Challenge of COVID-19: One Health Care Site's Leadership Response to the Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic created an extremely disruptive challenge for health care leaders that required a rapid, dynamic, and innovative response. The purpose of this manuscript is to share the leadership actions and decisions at Mayo Clinic in Florida during the first 6 months of the pandemic (February to July 2020). We note 4 strategies that contributed to an effective response: 1) Leverage experience with disaster preparedness and mobilize regional and national networks; 2) utilize surge models to anticipate and address supply chain issues as well as practical and financial effects of the pandemic; 3) adapt creatively to establish new safety and procedural protocols in various areas for various populations; and 4) communicate timely information effectively and be the common source of truth. Mayo Clinic in Florida was able to address the surges of patients with COVID-19, provide ongoing tertiary care, and restore function within the first 6 months with new, strengthened practices and protocols.
A new method to estimate global freshwater phytoplankton carbon fixation using satellite remote sensing: initial results

Freshwater phytoplankton carbon fixation is an important water quality parameter that can provide information about the health of lake ecosystems as well as their impacts on regional carbon cycling...
The Impact of Interpersonal Skills Training on the Transition to Radiotherapy Student Clerkship.

ABSTRACT Introduction/Background Preparing students for clerkship in a radiation oncology setting requires complex, sensitive, and specific interpersonal skills training. Oncology patients undergoing radiation therapy treatment present with unique needs given the harrow of a cancer diagnosis. Although the radiation therapy profession's credentialing body requires interpersonal skills training, there is little research specific to radiotherapy student communication training across the globe. Literature review Searches for relevant literature were conducted and the following themes emerged: transitions to clinical training, value of interpersonal skills and value of interprofessional education. The majority of literature identified supported medical, nursing, physical therapy and physician's assistant education. Discussion Radiotherapy students often participate in the same undergraduate coursework with various health science disciplines, with a common goal of providing optimal patient care. This diverse classroom of radiation therapy, radiologic technology, and dosimetry students mimic the interdisciplinary team in radiation oncology, preparing students for clerkship in a safe and authentic environment. Interprofessional education serves as a vehicle to enhance the transition from the classroom to the clinic while simulating the alliance of healthcare professionals required for team-based care. Conclusion Interpersonal skills training specific to radiation therapy education is lacking and further limited to research conducted in Canada, New Zealand, and Australia. The gap in research in the United States provides many areas of opportunity.
The association between risky decision making and cocaine conditioned place preference is moderated by sex.

Abstract Background Excessive risk taking is a characteristic trait of several psychiatric conditions, including substance use disorders. High risk-taking (HiR) rats self-administer more cocaine compared to low risk-taking (LoR) rats. However, research has not determined if risk taking is associated with enhanced cocaine conditioned place preference (CPP). Methods Male and female Sprague Dawley rats (n = 48 each sex) were first tested in the risky decision task (RDT), in which a response on one lever resulted in safe delivery of one food pellet, and a response on a different lever resulted in delivery of two pellets and probabilistic delivery of foot shock. Following RDT training, rats were tested for cocaine CPP. The first session was a pretest that measured rats’ preference for three compartments that provided different visual and tactile cues. Rats then learned to associate one compartment with cocaine (either 10.0 mg/kg or 20.0 mg/kg; i.p.) and one compartment with saline (1.0 ml/kg; i.p.) across eight conditioning sessions. Finally, rats explored all three compartments in a drug-free state. Results Sex significantly moderated the association between risky decision making and cocaine CPP. While increased risk aversion was somewhat positively associated with cocaine CPP in males, increased risk taking was positively correlated with cocaine CPP in females. Conclusions These results highlight the moderating role of sex on the relationship between risky decision making and cocaine reward.
New Approaches to Solution Reaction Dynamics: Quantum Control and Ultrafast Diffraction

Much progress has been made in recent years in the theoretical and computational treatments of solution reaction dynamics. On the computational side alone, several hundred papers have been published over the past 20 years as described in a recent review article. Our own work on the molecular dynamics of solution reactions (much of which has been in collaboration with Casey Hynes and Raphy Levine) has covered: I2 and ICN photodissociation in rare gas solution,2–6 atom replacement in rare gas solution,7–10 SN211–15 and SNI16 reactions in water, the effect of rare gas solvent on unimolecular dissociation and IVR,17 parallels to gas phase dynamics,7,8 stochastic models of solution reactions,19 and the link between reaction dynamics and solution structure.20
The Renointestinal Relationships: Normal and Pathologic Anatomy

Many patients with renal disease present with symptoms that seem to arise from the digestive tract. Practically every case of urinary tract disease is known to be accompanied by some gastrointestinal complaint of a transitory or permanent character, particularly nausea, vomiting, epigastric distress, constipation, or diarrhea.14 Gastrointestinal symptoms alone have been noted in up to 43% of patients. Since clinical investigation of such patients is often started with barium contrast studies, it is important to recognize that characteristic effects on specific portions of the bowel may uncover the primary renal disease and redirect the course of evaluation.22
Testing Composite Superconductor for the LRL Baseball Magnet

This study presents the evaluation of the superconductor to be used in the large baseball magnet under construction at LRL Livermore [1]. Sample conductors were purchased from several suppliers and wound into solenoids for testing; each sample was comparable in quality and performance to that required for the baseball magnet. To produce the high magnetic field required for the conductor test, a “split-pair” magnet was built of niobium-tin superconducting tape. Then a solenoid of sample superconductor was located between the halves of the split-pair magnet and energized. In addition the short-sample performance of the conductors was measured, along with their ability to share current between the superconductor and stabilizing copper. Construction techniques and experimental results are presented both for the split-pair magnet and for the baseball sample conductors.
Clinical relevance of tixocortol pivalate-positive patch tests and questionable bioequivalence of different hydrocortisone preparations.

Summary Background Tixocortol-21-pivalate (tixocortol pivalate) is used as a surrogate marker for contact allergy to hydrocortisone and other corticosteroids. Objective To review the results of repeated open application testing (ROAT) and patch testing with hydrocortisone creams and ointments in tixocortol pivalate patch test-positive patients. Methods ROAT was performed when the history of hydrocortisone contact dermatitis was negative or equivocal. Hydrocortisone cream and/or ointment patch tests were performed in patients with and without histories of hydrocortisone contact dermatitis. Results were excluded in patients allergic to vehicle ingredients. Results ROAT was positive in 15 of 20 patients (75%) with hydrocortisone cream versus 6 of 16 (38%) with hydrocortisone ointment (p = 0.02). Patch testing was positive with hydrocortisone cream in 23 of 27 patients (85%) versus 1 of 14 (7%) with hydrocortisone ointment (p < 0.0001). Only 1 of 26 tixocortol pivalate patch test-negative patients had a positive patch test with hydrocortisone cream caused by a vehicle ingredient. Conclusions Clinical relevance was shown in most patients with positive tixocortol pivalate patch tests. Hydrocortisone creams gave positive patch tests and positive repeated open application tests much more often than hydrocortisone ointments. There were also significant differences in patch test reactivity among different hydrocortisone creams. We hypothesize that these differences may be explained by differences in hydrocortisone transepidermal penetration in different vehicles.
The role of splenectomy in the management of thalassemia.

A group of 58 children with severe Cooley’s anemia, half of them splenectomized, were reviewed from several of the more important clinical and hematologic aspects. Splenectomy eliminates the extracorpuscular mechanism responsible for the accelerated destruction of normal donor red cells in the patient’s circulation. This represents a lasting improvement and accounts for an increased longevity of normal blood supplements and a striking reduction of transfusion requirements. Less blood was required to maintain at least as good, and at times improved, hemoglobin levels. Estimates of duration of survival of the patient’s own erythrocytes suggest that the basic hemolytic defect is not altered significantly by this operative procedure. While transfusions and splenectomy promote the patient’s well being, growth in height and sexual development are retarded. Secondary sexual characteristics develop, if at all, later than in normal individuals and normal menses are rare. Cardiac failure occurred in 10 patients; all but one had been subjected to splenectomy. This group was characterized by cardiac enlargement, multiple arrhythmias and death with refractory heart failure, usually in the second decade of life. Cardiac complications are likely to be related to the heavy deposition of iron in the myocardium, and are comparable in this respect to a similar incidence in idiopathic hemochromatosis. One of the most serious problems in the management of Cooley’s anemia is the prevention and control of congestive heart failure. This will depend on the discovery of an effective method by which the heart can be made to unload its iron deposits. The increased susceptibility to infection following splenectomy in patients with severe Cooley’s anemia indicates that the normal immunologic responses inherent in the spleen remain intact despite the stress of a continuous hemolytic process.