cssi/SciSciGPT-SciSciNet huggingface dataset:
Nutrition in Acute Renal Failure: A Reappraisal for the 1990s

■ Objective: To review current concepts regarding the rationale for and choice of nutritional support and nutritional assessment techniques in patients with catabolic acute renal failure (ARF). ■ Data sources: Published references, conference proceedings, and personal observations. ■ Conclusions: Providing optimal nutritional support to patients with catabolic ARF requires recognition of the nutritional requirements of patients with catabolic ARF, modification of standard nutritional assessment techniques, and familiarity with the unique characteristics of current forms of renal replacement therapies. Use of these techniques may allow for the improvement of nutritional status in this patient population and ultimately have a positive effect on outcome.
UV photolysis of HNO_3 on the ice film

Photolysis of nitric acid(HNO3) in the gas phase at 253 K and 295 K,on ice films at 253 K,was studied by using 308 nm excimer laser photolysis combined with cavity ring-down spectroscopy.The NO2* quantum yield and absorption cross section were directly measured.The results showed NO2* +· OH is a predominant photolysis pathway for the gas-phase photolysis of HNO3 at 308 nm.The 308 nm absorption cross section of HNO3 on ice films is(1.21±0.31)×10-18 cm2 · molecule-1 at 253 K which is about 3 orders of magnitude larger than its gas-phase cross section value of(1.24±0.19)×10-21 cm2 · molecule-1 at 295 K and(8.50±0.24) ×10-22 cm2 · molecule-1 at 253 K.The NO2* quantum yield from the HNO3 photolysis on ice films is 0.60±0.34 at 253 K.
Information processing in auditory cortex

In contrast to the visual system, the auditory system has longer subcortical pathways and more spiking synapses between the peripheral receptors and the cortex. This unique organization reflects the needs of the auditory system to extract behaviorally relevant information from a complex acoustic environment using strategies different from those used by other sensory systems. The neural representations of acoustic information in auditory cortex include two types of important transformations: the non-isomorphic transformation of acoustic features and the transformation from acoustical to perceptual dimensions. Neural representations in auditory cortex are also modulated by auditory feedback and vocal control signals during speaking or vocalization. The challenges facing auditory neuroscientists and biomedical engineers are to understand neural coding mechanisms in the brain underlying such transformations. I will use recent findings from my laboratory to illustrate how acoustic information is processed in the primate auditory cortex and discuss its implications for neural processing of speech and music in the brain as well as for the design of neural prosthetic devices such as cochlear implants. We have used a combination of neurophysiological techniques and quantitative engineering tools to investigate these problems.
Soft PEDOT:PSS aerogel architectures for thermoelectric applications

In this study, we present the first characterization of pure PEDOT:PSS aerogels fabricated via a facile and reproducible freeze–drying technique using no additional crosslinking agents, and it is demonstrated that these materials provide a promising path to new classes of polymeric thermoelectric materials. The morphology, chemical composition, and thermoelectric properties of these robust and mechanically stable aerogels were investigated upon treatment with ethylene glycol. By direct comparison to fully dense PEDOT:PSS thick films, it is shown that the electronic portion of thermoelectric transport in PEDOT:PSS was remarkably unaffected by morphological porosity, presenting exciting opportunities for novel soft materials that simultaneously integrate thermoelectric behavior while also capitalizing on the high surface area scaffolding accessible in such aerogel architectures. © 2016 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2017, 134, 44070.
Effects of Aging on the Fate and Bioavailability of Cerium Oxide Nanoparticles to Radish (Raphanus sativus L.) in Soil

The fate and impact of cerium oxide nanoparticles (CeO2NPs) on soil-grown plants have been intensively studied. However, all previous studies were performed in freshly prepared soils, without considering the temporal changes of the properties of CeO2NPs in the environment. A growing body of evidence suggests that the properties of CeO2NPs will change with aging, and therefore, it is essential to understand how the aging process affects the fate and bioavailability of CeO2NPs in the environment. In this study, the effects of aging on the fractionation of CeO2NPs in a silty loam soil and their bioavailability to radish were investigated. The results indicated that aging for 7 months did not affect the fractionation of CeO2NPs in soil. However, the aging process significantly increased the concentration of Ce3+ in soil. The soil with aged CeO2NPs contained a 40.5% higher concentration of Ce3+ than soil with fresh CeO2NPs. The aging process also resulted in a significantly higher Ce concentration in the radis...
Hickam’s dictum: Creutzfeldt Jakob disease in a patient with concurrent stage IV esophageal carcinoma (P5.190)

Objective: A patient with esophageal carcinoma presented with rapid clinical decline and determined to have CJD despite repeat negative 14-3-3 protein Background: Case Report Methods: 69 yo male previously receiving chemotherapy (herceptin and capecitabine) for stage IV esophageal carcinoma presented with progressively worsening confusion over the past 2 weeks. Results: Patient received 9 cycles of herceptin and capecitabine. Symptoms included short term memory loss, blurred vision, dizziness, headache, nausea. His exam was pertinent for disorientation to place, situation and cognitive problems with difficulty in calculating serial 7’s and 1/3 recall. The exam was nonfocal otherwise. MRI brain revealed diffuse restricted diffusion in the cortex, right caudate and left hippocampus. EEG showed right posterior quadrant slowing with PLEDs (periodic lateralized epileptiform discharges). Levetiracetam was started due to suspicion that he may be having subclinical seizures. Differentials were broad including encephalitis, metastasis, seizure edema, or medication effect such as capecitabine induced leukoencephalopathy. CSF analysis performed was non-inflammatory with 0 nucleated cells, normal protein and glucose, 14-3-3 protein negative. He continued to have a decline in mental status and hypnic jerks. Repeat MRI brain a week later revealed no significant change in hyperintensities on T2 imaging and no enhancement. Repeat LP again was non-inflammatory with a negative 14-3-3 protein however amyloid and tau protein returned with significantly elevated total tau protein without phosphorylated tau or amyloid which with the imaging is consistent with Creutzfeldt Jakob Disease (CJD). Conclusions: Certain labs, although helpful may not always provide the answer and can be misleading. Occam’s razor posits that the simplest explanation is usually the correct one and in this patient it was initially thought that his esophageal carcinoma was in some way related to this presentation. Hickam’s dictum, the counterargument to Occam’s razor can sometimes occur and one must maintain a broad differential during evaluation. Disclosure: Dr. Lane has nothing to disclose. Dr. Anandaram has nothing to disclose. Dr. Cichowski has nothing to disclose. Dr. Nye has nothing to disclose.
Categorizing Fetal Heart Rate Variability with and without Visual Aids

The present study examined the ability to categorize fetal heart rate (FHR) variability with and without the use of visual aids. Participants were instructed to categorize examples of FHR images into four categories of variability defined by the National Institute of Child Health and Human Development: absent, minimal, moderate, or marked. Participants took part in three visual aid conditions: prototypical aids, nonprototypical aids, and no visual aids. Each participant was required to categorize examples of prototypical and nonprototypical FHR images in each of the four categories of variability. The results showed that participants responded faster to and correctly categorized more prototypical FHR images compared to nonprototypical images. Moreover, the use of prototypical and nonprototypical visual aids significantly improved participants’ performance in categorizing the FHR images. These results suggest that an alignable, high similarity visual aid can improve the ability to correctly categorizing FH...
A de novo genome assembler based on MapReduce and bi-directed de Bruijn graph

The next generation sequencing (NGS) techniques have enabled biologists to generate large DNA sequences in a high-throughput and low-cost way. Assembly of NGS reads still face great challenges due to the short reads and enormous high volume. In this paper, we presented a new assembler, called GAMR, which is based on bi-directed de Bruijn graph and implemented using MapReduce framework. We designed distributed algorithm for each step in GAMR, making it scalable in assembling large-scale genomes. We evaluated GAMR using GAGE's data and compared it against other NGS assemblers. The results showed GAMR assembled contigs and scaffolds with better accuracy and longer N50 values.
Analysis of packet loss in a large-scale DSRC field operational test

Dedicated Short-Range Communication (DSRC) intends to improve transportation safety by using wireless technology to allow vehicles to exchange safety-awareness message between them. Using a large empirical dataset collected from a field operational test of nearly 3000 vehicles operating around Ann Arbor, Michigan, we characterize the packet-level performance of safety messages exchanged among vehicular encounters. Specifically, to better understand the real-world operating conditions of the vehicular wireless channel, the characteristics of Packet Reception Ratio (PRR) and Inter-Packet Gap (IPG) behaviors and temporal and spatial correlations are examined. Analysis of vehicle-pair encounters shows DSRC packet losses differing from other, static-node wireless beaconing networks, due mainly to the vehicles' high mobility and the possibilities of signal scatterers and/or obstructers that may come between them. As long bursts of consecutively lost packets could jeopardize vehicle safety awareness, IPG is explored further, with short-gapped consecutive losses commonly uncorrelated and longer gaps exhibiting temporal correlation tendencies. The findings of this paper can be used to inform channel models for DSRC systems, which in turn can produce meaningful simulation results.
Acceptance of the 2016 Roebling Medal of the Mineralogical Society of America

President Lange, Friends, and Colleagues: What a thrill to be here today, celebrating mineralogy. And Rus. Thank you for those most kind remarks. Your unwavering support, both professional and personal, has played a significant role through most of my career, and I am more grateful than I can easily express. Receiving a medal named for Washington Roebling has special meaning for me, as I feel a kinship with the great engineer in at least two significant ways. First is our mutual love of mineralogy. My passion for minerals was kindled in eighth grade, when I was fortunate to have Wilfred Welsh as my science teacher. Bill Welsh was a soft-spoken, engaged, but initially unassuming teacher. He lined his classroom with glass cases and filled them with beautiful minerals. He observed me lingering after class, examining one specimen after another, and he offered to teach me more. He gave me a starter collection of 100 specimens, mineral field guides, and mimeographed directions to Paterson and Franklin, New Jersey (favored haunts of Washington Roebling, by the way). I visited those great localities again and again, including a memorable Franklin, New Jersey, date with Margee in 1966—50 years ago. We still have fluorescent specimens collected that night. Needless to say, I was hooked—both by mineralogy and by Margee, who has shared in every step of this journey. Fast forward to freshman year at MIT, where my arrival coincided with that of the ebullient, passionate David R. Wones—my mineralogy teacher and subsequent Masters Thesis adviser. What an inspiration Dave was! I had gone to …
Cyclodextrin-assisted capillary electrophoresis for determination of the cyclic nitramine explosives RDX, HMX and CL-20 comparison with high-performance liquid chromatography.

Abstract A sulfobutyl ether–β-cyclodextrin-assisted electrokinetic chromatographic method was developed to rapidly resolve and detect the cyclic nitramine explosives 2,4,6,8,10,12-hexanitro-2,4,6,8,10,12-hexaaza-isowurtzitane (CL-20), octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine (HMX) and hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) and their related degradation intermediates in environmental samples. Development of the electrophoretic method required the measurement of the aqueous solubility of CL-20 which was determined to be 3.59±0.74 mg/l at 25 °C (95% confidence interval, n =3). The performance of the method was then compared to results obtained from existing high-performance liquid chromatography methods including US Environmental Protection Agency method 8330.
Small incident angle transient scattering from shallow cavities in a ground plane

This work presents applications for modeling electromagnetic scattering from two-dimensional cavities embedded in a perfectly conducting ground plane. First, the problem is discretized in time with Newmark's method, then solved using finite-element boundary-integral technique. This approach computes solutions in both cavities at the same time to strictly enforce coupled boundary conditions. Numerical experiments are conducted on rectangular cavities of different depths spaced at different intervals using Gaussian fields incident at small angles, between 10 and 30 degrees.
The Modulating Effects of Benign Prostate Enlargement Medications on Upgrading Predictors in Patients with Gleason 6 at Biopsy.

Background: Upgrading following prostate biopsy is very common in clinical practice. This study investigated whether the use of 5-alpha reductase inhibitors (ARI)
Deep Semantic Role Labeling: What Works and What’s Next

We introduce a new deep learning model for semantic role labeling (SRL) that significantly improves the state of the art, along with detailed analyses to reveal its strengths and limitations. We use a deep highway BiLSTM architecture with constrained decoding, while observing a number of recent best practices for initialization and regularization. Our 8-layer ensemble model achieves 83.2 F1 on theCoNLL 2005 test set and 83.4 F1 on CoNLL 2012, roughly a 10% relative error reduction over the previous state of the art. Extensive empirical analysis of these gains show that (1) deep models excel at recovering long-distance dependencies but can still make surprisingly obvious errors, and (2) that there is still room for syntactic parsers to improve these results.
You can teach computer networking in high school

NetsBlox is a visual blocks-based programming language extending Snap! with a few carefully selected abstractions to support distributed programming. In this paper, we argue that with the help of NetsBlox, some of the fundamental concepts of computer networking can be included in the high school computer science curriculum. Specifically, we describe a set of curricular units that would fit nicely in the AP Computer Science Principles course. High school students in two short-term studies showed great engagement and were able to complete simple computer networking tasks.
Conditioned attenuation of auditory brainstem responses in dolphins warned of an intense noise exposure: Temporal and spectral patterns.

Conditioned reductions in hearing sensitivity were elicited in two bottlenose dolphins by pairing a 10-kHz tone (the conditioned stimulus) with a more intense tone (the unconditioned stimulus) at 20, 40, or 80 kHz. Hearing was assessed via noninvasive measurement of auditory brainstem responses (ABRs) to 20 - to 133-kHz tone bursts presented at randomized intervals from 1 to 3 ms. ABRs within each trial were obtained by averaging the instantaneous electroencephalogram, time-locked to tone burst onsets, over 2- to 3-s time intervals. In initial testing, ABR amplitudes were reduced (relative to baseline values) in one dolphin after the conditioned stimulus, but before the unconditioned stimulus, demonstrating conditioned hearing attenuation. In subsequent testing with both dolphins, ABRs were attenuated throughout the entire 31-s trial. Maximum ABR threshold shifts occurred at and above the unconditioned stimulus frequency and were above 40 dB for some conditions. The results (1) confirm that dolphins can b...
Current Childbirth Options and Parental Decision Making

It is essential that the mental health consultant have a working understanding of the spectrum of childbirth care options now available (at least in many large metropolitan areas) together with a grasp on the intellectual and emotional factors that influence the decision-making process for parents choosing a particular option. Because of the nature of pregnancy and childbirth, such choices are inextricably bound up with attitudes about becoming a parent in the first place, with attitudes toward the medical and allied health professions, and with value systems related to child care. These issues become much more complicated than choosing a surgeon or a hospital in which to have one’s gallbladder removed.
Procedure diagnostiche razionali

Quando trattiamo un paziente con dolore addominale acuto si e tentati di ricorrere all’uso estensivo di esami ausiliari: questo comporta l’instaurarsi, nei PS, di routines che prevedono che il paziente affetto da dolore addominale acuto venga sottoposto ad una RXA e ad una serie di esami ematici che generalmente comprendono l’emocromo completo, esami ematochimici ed il dosaggio dell’amilasi sierica.
Hair Pulling Behavior Reported by African American and Non-African American College Students

Of the few attempts to determine the prevalence rate of trichotillomania, virtually none have investigated potential ethnic differences. The present study provides data on the prevalence of hair twirling and hair pulling behavior among 176 African American and 422 non-African American students and systematically explores differences between these 2 groups. Fully 10.2% of the sample reported hair pulling that resulted in noticeable hair loss, with African American women reporting the highest rate (15.7%). Overall, 2% of participants responded consistently with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; American Psychiatric Association, 2000) criteria for trichotillomania; rates did not differ significantly among genders or ethnic backgrounds. African Americans, and especially African American women, were more likely than other participants to report hair pulling in response to skin irritation. Results are discussed in the context of previous research, the importance of hair care in the African American community, and directions for future research.
Emergence of norovirus GII.P16-GII.2 strains in patients with acute gastroenteritis in Huzhou, China, 2016-2017.

In late 2016, an uncommon recombinant NoV genotype called GII.P16-GII.2 caused a sharp increase in outbreaks of acute gastroenteritis in different countries of Asia and Europe, including China. However, we did not observe a drastic increase in sporadic norovirus cases in the winter of 2016 in Huzhou. Therefore, we investigate the prevalence and genetic diversity of NoVs in the sporadic acute gastroenteritis (AGE) cases from January 2016 to December 2017 in Huzhou City, Zhejiang, China. From January 2016 to December 2017, a total of 1001 specimens collected from patients with AGE were screened for NoV by real-time RT-PCR. Partial sequences of the RNA-dependent RNA polymerase (RdRp) and capsid gene of the positive samples were amplified by RT-PCR and sequenced. Genotypes of NoV were confirmed by online NoV typing tool and phylogenetic analysis. Complete VP1 sequences of GII.P16-GII.2 strains detected in this study were further obtained and subjected into sequence analysis. In total, 204 (20.4%) specimens were identified as NoV-positive. GII genogroup accounted for most of the NoV-infected cases (98.0%, 200/204). NoV infection was found in all age groups tested ( 60 years), with the 5–15 year age group having the highest detection rate (17/49, 34.7%). Higher activity of NoV infection could be seen in winter-spring season. The predominant NoV genotypes have changed from GII.Pe-GII.4 Sydney2012 and GII.P17-GII.17 in 2016 to GII.P16-GII.2, GII.Pe-GII.4 Sydney2012 and GII.P17-GII.17 in 2017. Phylogenetic analyses revealed that 2016–2017 GII.P16-GII.2 strains were most closely related to Japan 2010–2012 cluster in VP1 region and no common mutations were found in the amino acids of the HBGA-binding sites and the predicted epitopes. We report the emergence of GII.P16-GII.2 strains and characterize the molecular epidemiological patterns NoV infection between January 2016 and December 2017 in Huzhou. The predominant genotypes of NoV during our study period are diverse. VP1 amino acid sequences of 2016–2017 GII.P16-GII.2 strains remain static after one year of circulation.
Immune T cells can transfer and boost anti-breast cancer immunity

ABSTRACTThis proof-of-concept study investigates the immune effects in metastatic breast cancer (MBC) patients after “vaccination” with activated T cells (ATC) armed with anti-CD3 x anti-HER2 bispecific antibody (HER2 BATs) followed by immune consolidation with immune ATC “boost” after high dose chemotherapy (HDC) and autologous stem cell transplant (SCT). Approximately 2 weeks after completion of vaccination portion of the study, immune T cells were obtained by leukopheresis, activated and expanded ex vivo and re-infused after HDC and SCT to test the hypothesis that transfer of immune unarmed ATC would accelerate reconstitution of anti-tumor activity after SCT. Eight metastatic breast cancer (MBC) patients received 8 infusions of HER2 BATs, low dose IL-2, and GM-CSF in the first part of the protocol to induce adaptive cellular and humoral responses. In the “boost” portion of the protocol, 6 of 8 patients received multiple infusions of unarmed ATC post SCT. There were no dose-limiting toxicities or delays...
Modeling Causal Relationships in Quality Improvement

Taking the time to plan a quality improvement project before starting the project improves the likelihood of success. Understanding the tools that can be utilized for identification of a problem, the causes behind it, and the development of the theoretical framework of the planned improvement are crucial. Fishbone diagrams or cause and effect diagrams are often utilized to identify the root causes leading to an identified problem. Keydriver diagrams can provide the structure for a quality improvement project, establishing the aim and identifying the drivers and interventions that lead to change. This paper reviews these two quality improvement tools. When beginning a quality improvement project, several tools can be used to begin identifying where to target efforts. Utilizing process maps and failure modes and effects analysis (FMEA) can help define a process, identify failures, and develop interventions to be considered. Process maps identify potential gaps or excess steps and reveal sequential relationships. FMEAs aid in the development of causal relationships between a failure mode and its effects, priming the quality improver to create interventions. An additional way to model causal relationships is with fishbone diagrams and key driver diagrams. The fishbone diagram enables teams to consider why a problem has occurred and search for the root causes. The key driver diagram provides the ultimate aim of the project, identifies the drivers which will affect accomplishing the aim, and the interventions that affect the identified drivers. This paper will carefully examine both fishbone diagrams and key driver diagrams.
Assessing Behavioral Styles Among Nurse Managers: Implications for Leading Effective Teams

Nurse leaders must use behaviors that foster effective teams. The purpose of this study was to determine the behavioral style by 3,396 nurse leaders who attended leadership and communication continuing education courses. Sessions included identifying behavioral style preferences using the DiSC® Personal Profile Instrument. Of the four behavioral dimensions, Dominance, Influence, Steadiness, and Conscientiousness, 73% scored highest in Dominance and Conscientiousness. The remaining 27% scored highest in preferences for Influence and Steadiness. Nursing leaders may benefit from awareness of differences in behavioral style preferences to enhance communication and team effectiveness, as well as improve satisfaction among team members.
Per-Oral Pyloromyotomy (POP) for Medically Refractory Post-Surgical Gastroparesis.

Post-surgical gastroparesis (psGP) is putatively related to vagal denervation from either therapeutic transection or inadvertent injury. Here, we present a series of patients undergoing endoscopic per-oral pyloromyotomy (POP) as a treatment for medically refractory psGP. Patients identified from a prospectively maintained database of patients undergoing POP procedures at our institution from January 2016 to January 2018 were included. Surgical history, symptom scores, and gastric emptying studies before and 3 months after POP were additionally recorded. During the study period, 177 POP procedures were performed, of which 38 (21.5%) were for psGP. The study cohort was 84.2% female with a mean body mass index of 27.6 kg/m2 and mean age of 55.2 years. Common comorbidities included hypertension (34.2%), depression (31.6%), and gastroesophageal reflux disease (28.9%). Hiatal/paraesophageal hernia repair (39.5%) or fundoplication (36.8%) preceded psGP diagnosis most often. The mean operative time was 30 ± 20 min. There were no intraoperative complications. Mean postoperative length of stay was 1.2 days. There were two readmissions within 30 days, one for melena and one for dehydration. The mean improvement in total Gastroparesis Symptom Index Score was 1.29 (p = 0.0002). The mean 4-h gastric retention improved from a pre-POP mean of 46.4 to 17.9% post-POP. Normal gastric emptying was noted in 50% of subjects with available follow-up imaging. POP is a safe and effective endoscopic therapy for patients with psGP. POP should be considered a reasonable first-line option for patients with medically refractory psGP and may allow stomach preservation.
Predicting crack initiation site in polycrystalline nickel through surface topography changes

Abstract Fatigue loading generates plastic deformation and strain localization on the surface of polycrystalline metals, which are known to be the precursor for crack initiation. The plastic deformations manifest themselves in the form of surface roughening that can be characterized using surface profiling techniques. In this study, surface topology changes on the surface of a nickel specimen under cyclic loading are monitored and analyzed to investigate the correlation between surface topography changes and crack initiation. Defining the surface roughness parameters as the damage index, an algorithm was formulated to predict the crack initiation location well before the formation of a visible crack. In addition, the crack initiation time can also be determined based on the saturation of the surface roughness damage index as well as the rebound of the surface height near the crack initiation location.
Clinical Outcomes After Anterior Shoulder Stabilization in Overhead Athletes: An Analysis of the MOON Shoulder Instability Consortium:

Background:Traumatic anterior shoulder instability is a common condition affecting sports participation among young athletes. Clinical outcomes after surgical management may vary according to patie...
Combining Isoscapes with Tissue-Specific Isotope Records to Recreate the Geographic Histories of Fish

After the Deepwater Horizon (DWH) oil spill, interest in marine animal movement was heightened by recognition that some individual animals had been cryptically exposed to the oil, and that some of these exposed individuals later moved, introducing oil contamination to geographic areas that were beyond the initial domain of direct oil impact. Forensic methods based on internally recorded stable-isotope records can be used to address the issue of movement by contaminated individuals. Different tissues provide stable-isotope histories that reflect different periods in the individual’s history, ranging from just a few recent days in the case of blood plasma to the entire lifetime in the case of eye lenses and otoliths. Isotopic offsets between tissue types (e.g., liver and muscle) within the same individual can be used to measure the relative site fidelities of different individuals. Among individuals that have low site fidelity, geographic movements can be estimated by comparing lifetime isotope trends with background maps of isotope variation (isoscapes). The process of isotope conservation within the vertebrate eye lens is described, and practical application of forensic methods and data interpretation are discussed.
Transferring Random Samples in Actuator Systems for Binary Damage Detection

Data-driven models can accurately estimate the condition of systems, for example a hydraulic actuator. However, maintenance on the system can lower the predictive ability of condition models by changing the marginal and conditional distributions of the data. In this study, we propose to use transfer learning to address this issue in the context of a hydraulic actuator. Transfer learning aims to use knowledge from one system to improve modeling in another. This work uses random sampling to transfer samples between actuator rebuilds to predict a binary indicator of system damage in a rebuilt actuator. Features are selected based on distributional differences. We find that successful transfer using random sampling can occur when features are selected appropriately. Also, transferring only the damage data allows the model to improve as more baseline data from the rebuilt actuator becomes available.
Preoperative Cognitive Assessment Recommendations for the Older Adult.

Abstract Purpose The purpose of this project was to identify the need for and to improve the preoperative cognitive assessment of the older adult. Design A retrospective chart review was used to explore the incidence of postoperative delirium (PD) and characteristics associated with it. Methods A retrospective chart review was used to identify the incidence of PD in a community hospital. The data were analyzed using descriptive statistics for trends in demographic and physiological characteristics of older adults undergoing elective hip or knee surgery. Findings The incidence of PD was found to be 11%. Older adults with PD had an increased mean age and comorbid conditions. PD was associated with a mean increase in hospital stay, postoperative complications, and 30-day readmission. Conclusions Preoperative cognitive assessment can identify high-risk patients, stratify care, medically optimize the older adult before surgery, and improve perioperative outcomes.
Regional Phenotypic Differences of the Opener Muscle in Procambarus clarkii: Sarcomere Length, Fiber Diameter, and Force Development

The opener muscle in the walking legs of the crayfish (Procambarus clarkii) has three distinct phenotypic regions although innervated by only one excitatory motor neuron. These regions (distal, central, and proximal) have varied biochemistry and physiology, including synaptic structure, troponin-T levels, fiber diameter, input resistance, sarcomere length, and force generation. The force generated by the central fibers when the excitatory neuron was stimulated at 40 Hz was more than the force generated by the other regions. This increase in force was correlated with the central fibers having longer sarcomeres when measured in a relaxed claw. These data support the idea that the central fibers are tonic-like and that the proximal fibers are phasic-like. The addition of serotonin directly on the fibers was hypothesized to increase the force generated by the central fibers more than in the other regions, but this did not occur at 40-Hz stimulation. We hypothesized that the central distal fibers would generate the most force due to the arrangement on the apodeme. This study demonstrates how malleable the motor unit is with modulation and frequency of stimulation.
Automatic ID consultation for inpatients with COVID-19: point, counterpoint, and a single-center experience

There are many unknowns with regard to COVID-19 clinical management, including the role of Infectious Diseases Consultation (IDC). As hospitalizations for COVID-19 continue, hospitals are assessing how to optimally and efficiently manage COVID-19 inpatients. Typically, primary teams must determine when IDC is appropriate, and ID clinicians provide consultation upon request of the primary team. IDC has been shown to be beneficial for many conditions; however, the impact of IDC for COVID-19 is unknown. Herein, we discuss the potential benefits and pitfalls of automatic IDC for COVID-19 inpatients. Important considerations include the quality of care provided, allocation and optimization of resources, and clinician satisfaction. Finally, we describe how automatic IDC changed throughout the COVID-19 pandemic at a single academic medical center.
Utilizing Electronic Medical Records to Standardize Handoffs in Academic Ophthalmology

Purpose Formalized handoff procedures have been shown to increase patient safety and quality of care across multiple medical and surgical specialties,1–4 but literature regarding handoffs in ophthalmology remains sparse. We instituted a standardized handoff utilizing an electronic medical record (EMR) system to improve care for patients shared by multiple resident physicians across weekday, weeknight, and weekend duty shifts. We measured efficiency, efficacy, and resident satisfaction before and after the standardized handoff was implemented. Methods Resident physicians surveyed were primarily responsible for patient care on consult and call services at two quaternary academic medical centers in a major metropolitan area. Patient care was performed in outpatient, emergency, and inpatient settings. Annual anonymous questionnaires consisting of 6 questions were used to collect pre- and postintervention impressions of the standardized EMR handoff process from ophthalmology resident physicians (9 per year; 3 preintervention years and 1 postintervention year). An additional anonymous postintervention questionnaire consisting of 12 questions was used to further characterize resident response to the newly implemented handoff procedure. Results Prior to implementation of a standardized EMR-based handoff procedure, residents unanimously reported incomplete, infrequently updated handoff reports that did not include important clinical and/or psychosocial information. Following implementation, residents reported a statistically significant increase in completeness and timeliness of handoff reports. Additionally, resident perception of EMR handoff utility, efficiency, and usability were comprehensively favorable. Residents reported handoffs only added a mean of 6.5 minutes to a typical duty shift. Conclusion Implementation of our protocol dramatically improved resident perceptions of the handoff process at our institution. Improvements included increased quality, ease-of-use, and efficiency. Our standardized EMR-based handoff procedure may be of use to other ambulatory-based services.
MINORITY STUDENTS AND INTEGRATIONAL ISSUES IN AN INTERNATIONAL UNIVERSITY IN KURDISTAN

Over the last few decades, professionals have searched for generalized strategies and techniques to integrate students, but most often these studies have not examined the specific needs of minority students, who are segregated on ground of religion or cultural issues practiced by them, making them different from the majority others. These students often belong to different religious ethnicity and they make up a much smaller percentage and as a result, their experiences and needs at times gets lost and goes undetected. This article intends to investigate the gap between the ideal level of integration and the existing level between diverse groups of students and offers solutions towards bridging the gap in an international university in Kurdistan, northern Iraq.
Gender, Subsistence, Change, and Resilience in Quinhagak’s Present and Past

Like many other Alaska Native communities, the Yup’ik people of Quinhagak follow a subsistence lifestyle that is multi-faceted, socially embedded, and specifically tailored to the land and water on which it is practiced. This paper provides a synthesis of Quinhagak residents’ perspectives on subsistence in both the present and the past, as documented in original interviews and in the literature, with a focus on how gendered social identities are enacted through these traditions. The Nunalleq site presents a unique opportunity to examine the time depth of local subsistence lifeways and their social iterations, as well as how these were affected by changing landscapes and climate—all realities of contemporary Quinhagak life, just as they were for the ancestors at Nunalleq. The interrelation of subsistence and sociality has implications for how we understand Yup’ik resiliency and survivance in the face of such changes.
Monitoring Neuromuscular Performance in Military Personnel.

A necessarily high standard for physical readiness in tactical environments is often accompanied by high incidences of injury due to overaccumulations of neuromuscular fatigue (NMF). To account for instances of overtraining stimulated by NMF, close monitoring of neuromuscular performance is warranted. Previously validated tests, such as the countermovement jump, are useful means for monitoring performance adaptations, resiliency to fatigue, and risk for injury. Performing such tests on force plates provides an understanding of the movement strategy used to obtain the resulting outcome (e.g., jump height). Further, force plates afford numerous objective tests that are valid and reliable for monitoring upper and lower extremity muscular strength and power (thus sensitive to NMF) with less fatiguing and safer methods than traditional one-repetition maximum assessments. Force plates provide numerous software and testing application options that can be applied to military’s training but, to be effective, requires the practitioners to have sufficient knowledge of their functions. Therefore, this review aims to explain the functions of force plate testing as well as current best practices for utilizing force plates in military settings and disseminate protocols for valid and reliable testing to collect key variables that translate to physical performance capacities.
Clinical Pharmacist Integration Into Veterans' Primary Care: Team Members Perspectives.

Background With the restructuring of primary care into patient-centered medical homes (PCMH), researchers have described role transformations that accompany the formation of core primary care teamlets (eg, primary care provider, registered nurse care manager, licensed practical nurse, medical support assistant). However, few studies offer insight into how primary care teamlets, once established, integrate additional extended team members, and the factors that influence the quality of their integration. Methods We examine the process of integrating Clinical Pharmacy Specialists (CPS) into primary care teams in the Veterans Health Administration (VHA). We conducted semi-structured interviews with CPS (n = 6) and clinical team members (n = 16) and performed a thematic analysis of interview transcripts. Results We characterize 2 ways CPS are integrated into primary care teamlets: in consultative roles and collaborative roles. CPS may be limited to consultative roles by team members' misconceptions about their competencies (ie, if CPS are perceived to handle only medication-related issues like refills) and by primary care providers' opinions about distributing responsibilities for patient care. Over time, teams may correct misconceptions and integrate the CPS in a more collaborative role (ie, CPS helps manage disease states with comprehensive medication management). Conclusions CPS integrated into collaborative roles may have more opportunities to optimize their contributions to primary care, underscoring the importance of clarifying roles as part of adequately integrating advanced practitioners in interprofessional teams.
When it only takes one to tango: assessing the impact of apomixis in the fern genus Pteris

PREMISE Apomixis (asexual reproduction by seed, spore, or egg) has evolved repeatedly across the tree of life. Studies of animals and angiosperms show that apomictic lineages are often evolutionarily short-lived and frequently exhibit different distributions than their sexual relatives. However, apomixis is rare in these groups. Less is known about the role of apomixis in the evolution and biogeography of ferns, in which ~10% of species are apomictic. Apomixis is especially common in the fern genus Pteris (34-39% of species); however, because of the limited taxonomic and geographic sampling of previous studies, the true frequency of apomixis and its associations with geography and phylogeny in this lineage remain unclear. METHODS We used spore analyses of herbarium specimens to determine reproductive mode for 127 previously unsampled Pteris species. Then we leveraged biogeographic and phylogenetic analyses to estimate the global distribution and evolution of apomixis in Pteris. RESULTS Among all Pteris species examined, we found that 21% are exclusively apomictic, 71% are exclusively sexual, and 8% have conflicting reports. Apomixis is unevenly distributed across the range of the genus, with the Paleotropics exhibiting the highest frequency, and has evolved numerous times across the Pteris phylogeny, with predominantly East Asian and South Asian clades containing the most apomictic species. CONCLUSIONS Apomixis arises frequently in Pteris, but apomictic species do not appear to diversify. Species that encompass both apomictic and sexual populations have wider ranges than exclusively sexual or apomictic species, which suggests that sexual and apomictic ferns could occupy separate ecological niches.
First Reported Case of Neointimal Hyperplasia in the Midportion of a Polytetrafluoroethylene Dialysis Graft

We report a case of stenosis involving the midportion of a polytetrafluoroethylene graft caused by the infiltration of fibroblasts into the lumen of the graft with the development of fibrovascular tissue.
Chapter 98 – Overall Summary

Publisher Summary This chapter summarizes the overall pattern of occurrence of malignancies in Los Angeles County. It demonstrates that cancer is not a single disease, but a collection of various diseases, each occurring because a different type of cell has grown out of control. The total of 72 different malignancies along with 12 combinations of cancers examined in various ways permitted by available information, demonstrates that excluding geographical considerations, every malignancy in some way or other gives evidence of occurring in a systematic, that is, a nonrandom, pattern, although in the case of a few very rare malignancies the number of cases is too small to be completely certain. Dramatic nonrandom patterns of occurrence sometimes are produced by exposures that are very personal and have nothing to do with pollution and malignancies with different patterns of occurrence can be safely assumed to have different causes, whether or not the latter are all known. In general, the degree of variability in risk goes far beyond age differences. The geographic distribution of high risk of disease was clearly nonrandom, but did not conform to the pattern that would have been predicted by available knowledge.
Measurement of the rates of synthesis and degradation of hypoxanthine-guanine phosphoribosyltransferase in human lymphoblasts.

The steady state amount of cellular proteins is determined by the net sum of both their rates of synthesis and degradation. Individual proteins in mammalian cells each have a characteristic rate of degradation as well as synthesis. In recent years, protein catabolism has gained increased recognition as a fundamental intracellular process: 1) during nutritional starvation, 2) in the regulation of enzyme levels, and 3) in the elimination of abnormal proteins.1,2,3
The Dark Side of the Band of Brothers: Explaining Variance in War Crimes

On July 25, 1950, an American infantry unit killed a large number of refugees near the South Korean village of No Gun Ri. On December 12, 1948, a British patrol killed twenty-five civilians near the Malayan village of Batang Kali. On March 16, 1993, members of the Canadian Airborne Regiment beat a Somali teenager to death. While each event is horrific, they also represent only one side of the story; many units in these conflicts, facing similar threats, did not kill civilians. This variation raises a critical question: why do some units participate in war crimes while other do not? To answer this question, I tested three explanations: socialization in the laws of war, civilian influence, and unit subcultures. First, I examined the military’s training and enforcement of the laws of war to test whether socialization could explain this variation. Second, I analyzed the influence of civilian leaders. If they exaggerate the importance of a conflict or dehumanize the enemy, units may be more likely to participate in war crimes. Third, I examined the role of unit subcultures. Units may develop beliefs that challenge organizational norms and encourage participation in war crimes. I tested these arguments in case studies of the Korean War, the Malayan Emergency, and the Canadian peacekeeping mission in Somalia. Each conflict provides variation in outcomes: some military units complied with the laws of war and others did not. Based on extensive archival research, I reached three conclusions. First, while the American, British and Canadian militaries as institutions inadequately trained soldiers in the laws of war, junior leaders could compensate and insure compliance with international law. Second, I found that civilian signaling had little effect: soldiers did not trust the statements of civilian leaders. Third, my research revealed that countercultural subcultures may increase the likelihood that units participate in war crimes. These countercultural beliefs have the greatest effect when junior leaders also support them or when junior leaders cannot control the unit. In these circumstances, junior leaders over reliance on punishment fuels the in-group-out-group dynamic that strengthens the subculture.
RNA interference in Histoplasma capsulatum demonstrates a role for α‐(1,3)‐glucan in virulence

Histoplasma capsulatum is a fungal pathogen that causes respiratory and systemic disease by proliferating within macrophages. While much is known about histoplasmosis, only a single virulence factor has been defined, in part because of the inefficiency of Histoplasma reverse genetics. As an alternative to allelic replacement, we have developed a telomeric plasmid-based system for silencing gene expression in Histoplasma by RNA interference (RNAi). Episomal expression of long RNAs that form stem-loop structures triggered gene silencing. To test the effectiveness of RNAi in Histoplasma, we depleted expression of a gfp transgene as well as two endogenous genes, ADE2 and URA5, and showed significant reductions in corresponding gene function. Silencing was target gene specific, stable during macrophage infection and reversible. We used RNAi targeting AGS1 (encoding alpha-(1,3)-glucan synthase) to deplete levels of alpha-(1,3)-glucan, a cell wall polysaccharide. Loss of alpha-(1,3)-glucan by RNAi yielded phenotypes indistinguishable from an AGS1 deletion: attenuation of the ability to kill macrophages and colonize murine lungs. This demonstrates for the first time that alpha-(1,3)-glucan is an important contributor to Histoplasma virulence.