cssi/SciSciGPT-SciSciNet huggingface dataset:
Failure to see money on a tree: inattentional blindness for objects that guided behavior.

How is it possible to drive home and have no awareness of the trip? We documented a new form of inattentional blindness in which people fail to become aware of obstacles that had guided their behavior. In our first study, we found that people talking on cell phones while walking waited longer to avoid an obstacle and were less likely to be aware that they had avoided an obstacle than other individual walkers. In our second study, cell phone talkers and texters were less likely to show awareness of money on a tree over the pathway they were traversing. Nonetheless, they managed to avoid walking into the money tree. Perceptual information may be processed in two distinct pathways – one guiding behavior and the other leading to awareness. We observed that people can appropriately use information to guide behavior without awareness.
Insig-dependent Ubiquitination and Degradation of Mammalian 3-Hydroxy-3-methylglutaryl-CoA Reductase Stimulated by Sterols and Geranylgeraniol *

The endoplasmic reticulum enzyme 3-hydroxy-3-methylglutaryl-CoA reductase produces mevalonate, which is converted to sterols and to other products, including geranylgeraniol groups attached to proteins. The enzyme is known to be ubiquitinated and rapidly degraded when sterols and nonsterol end products of mevalonate metabolism accumulate in cells. Here, we use RNA interference to show that sterol-accelerated ubiquitination of reductase requires Insig-1 and Insig-2, membrane-bound proteins of the endoplasmic reticulum that were shown previously to accelerate degradation of reductase when overexpressed by transfection. Alanine substitution experiments reveal that binding of reductase to Insigs and subsequent ubiquitination require the tetrapeptide sequence YIYF in the second membrane-spanning helix of reductase. The YIYF peptide is also found in the sterol-sensing domain of SCAP, another protein that binds to Insigs in a sterol-stimulated fashion. When lysine 248 of reductase is substituted with arginine, Insig binding persists, but the reductase is no longer ubiquitinated and degradation is markedly slowed. Lysine 248 is predicted to lie immediately adjacent to a membrane-spanning helix, suggesting that a membrane-bound ubiquitin transferase is responsible. Finally, we show that Insig-dependent, sterol-stimulated degradation of reductase is further accelerated when cells are also supplied with the 20-carbon isoprenoid geranylgeraniol, but not the 15-carbon farnesol, raising the possibility that the nonsterol potentiator of reductase regulation is a geranylgeranylated protein.
Adult weight gain and histopathologic characteristics of breast cancer among postmenopausal women.

BACKGROUND Although the link between postmenopausal breast cancer and adiposity is well established, the association between weight gain and specific histopathologic characteristics of breast carcinoma has not been studied carefully. METHODS Using 1200 incident invasive breast cancers among 44,161 postmenopausal women who were not taking hormone therapy in the American Cancer Society's Cancer Prevention Study II Nutrition Cohort, the authors computed age-adjusted rates and rate ratios (RR) for breast cancer by histology, stage, grade, and estrogen receptor (ER) and progesterone receptor (PR) status by categories of adult weight gain. RESULTS Age-adjusted rates of breast cancer were highest for women who reported the most weight gain, regardless of histologic type. For weight gain >60 pounds, compared with weight gain ≤20 pounds the RR for ductal carcinoma was 1.89 (95% confidence interval [95%CI], 1.53-2.34), and the RR for lobular carcinoma was 1.54 (95%CI. 1.01-2.33). Weight gain was associated with increased risk at every tumor stage and grade. The risk for regional or distant stage was elevated significantly in every category of weight gain and was 3 times higher among women who had the greatest weight gain (RR, 3.15; 95%CI, 2.21-4.48). Weight gain was associated with increased risk of ER-positive/PR-positive tumors (P for trend <.0001) but not ER-negative/PR-negative tumors (P for trend = .09). The results essentially remained unchanged when the analysis was restricted to women who had regular screening mammograms. CONCLUSIONS Excess adiposity is an important contributor to breast cancer risk among postmenopausal women, regardless of histologic type, and especially for tumors of advanced stage and high grade. Cancer 2006. © 2006 American Cancer Society.
Cytokine responses of bovine macrophages to diverse clinical Mycobacterium avium subspecies paratuberculosis strains.

Mycobacterium avium subsp. paratuberculosis (MAP), the causative agent of Johne's disease (JD) persistently infects and survives within the host macrophages. While it is established that substantial genotypic variation exists among MAP, evidence for the correlates that associate specific MAP genotypes with clinical or sub-clinical disease phenotypes is presently unknown. Thus we studied strain differences in intracellular MAP survival and host responses in a bovine monocyte derived macrophage (MDM) system. Intracellular survival studies showed that a bovine MAP isolate (B1018) and a human MAP isolate (Hu6) persisted in relatively higher numbers when compared with a sheep MAP isolate (S7565) at 24-hr, 48-hr and 96-hr post infection (PI). MDMs stimulated with B1018 up-regulated IL-10 at the transcript level and down-regulated TNFα at the protein and transcript levels compared with stimulations by the S7565 and Hu6. MDMs infected with Hu6 showed a down regulatory pattern of IL-10 and TNFα compared to stimulations by S7565. Cells stimulated with B1018 and Hu6 had low levels of matrix metalloprotease-3 (MMP3) and high levels of tissue inhibitor of metalloprotease-1 (TIMP1) at 96-hr PI relative to MDMs stimulated by S7565. Taken together, results suggest that the bovine (B1018) and the human (Hu6) MAP isolates lead to anti-inflammatory and anti-invasive pathways in the macrophage environment whereas the sheep (S7565) MAP isolate induces a pro-inflammatory pathway. Thus the infecting strain genotype may play a role in polarizing the host immune responses and dictate the clinicopathological outcomes in this economically important disease.
A facile approach to robust superhydrophobic 3D coatings via connective-particle formation using the electrospraying process

This work demonstrates a facile fabrication method to produce superhydrophobic coatings on chemically distinct materials using the electrospraying process. Coatings are mechanically robust, three-dimensional, and formed using a single fabrication step.
Biophysical neural spiking and bursting dynamics in reconfigurable analog VLSI

We study a range of neural dynamics under variations in biophysical parameters implementing extended Morris-Lecar and Hodgkin-Huxley models in three gating variables. The dynamics are emulated in NeuroDyn, an analog VLSI programmable neural emulation platform with generalized channel kinetics and biophysical membrane dynamics. We present simulation and measurement results and observe consistent agreement over a wide regime of tonic spiking and intrinsic bursting dynamics through the variation of a single conductance parameter governing calcium recovery.
Paramagnetic Resonance and Optical Absorption Spectra of Cr 3+ in MgO

The paramagnetic resonance spectrum of the trivalent chromium ion has been detected at a wavelength of 1.2 cm. The spectrum is isotropic with one line at $g=1.9800\ifmmode\pm\else\textpm\fi{}0.0006$. The hyperfine structure of the ${\mathrm{Cr}}^{53}$ isotope in its natural abundance was detected. The hyperfine structure constant $A=(1.60\ifmmode\pm\else\textpm\fi{}0.03)\ifmmode\times\else\texttimes\fi{}{10}^{\ensuremath{-}4}$ ${\mathrm{cm}}^{\ensuremath{-}1}$ permits an evaluation of the nuclear magnetic moment as 0.475 nm. The narrow line and the failure to observe any ground state splitting show that the trivalent chromium ion is exposed to a very pure cubic field. There is no indication of associated vacancies with the ${\mathrm{Cr}}^{3+}$ ion. Optical absorption lines were found at 16 000, 22 700, and 29 700 ${\mathrm{cm}}^{\ensuremath{-}1}$ as well as a beginning of absorption at 46 000 ${\mathrm{cm}}^{\ensuremath{-}1}$. The 16 000 ${\mathrm{cm}}^{\ensuremath{-}1}$ line is caused either by a quartet-doublet transition or by the ${\mathrm{Cr}}^{2+}$ ion. The other absorption lines can be fitted with $Dq=2270$ ${\mathrm{cm}}^{\ensuremath{-}1}$ and the $^{4}P$ state at 10 000 ${\mathrm{cm}}^{\ensuremath{-}1}$ above the $^{4}F$ state. An analysis of the paramagnetic and optical absorption spectra indicate very strong crystal field and some covalent bonding. Probably the ${\mathrm{Cr}}^{3+}$ and the surrounding six oxygen atoms have to be regarded as a very tightly knit unit.
Loop Current Eddy formation and baroclinic instability

Abstract The formation of three Loop Current Eddies, Ekman, Franklin, and Hadal, during the period April 2009 through November 2011 was observed by an array of moored current meters and bottom mounted pressure equipped inverted echo sounders. The array design, areal extent nominally 89° W to 85° W, 25° N to 27° N with 30–50 km mesoscale resolution, permits quantitative mapping of the regional circulation at all depths. During Loop Current Eddy detachment and formation events, a marked increase in deep eddy kinetic energy occurs coincident with the growth of a large-scale meander along the northern and eastern parts of the Loop Current. Deep eddies develop in a pattern where the deep fields were offset and leading upper meanders consistent with developing baroclinic instability. The interaction between the upper and deep fields is quantified by evaluating the mean eddy potential energy budget. Largest down-gradient heat fluxes are found along the eastern side of the Loop Current. Where strong, the horizontal down-gradient eddy heat flux (baroclinic conversion rate) nearly balances the vertical down-gradient eddy heat flux indicating that eddies extract available potential energy from the mean field and convert eddy potential energy to eddy kinetic energy.
BARDEN INLET, N.C. A CASE STUDY OF INLET MIGRATION

The migratory pattern of a small coastal inlet was examined in terms of the factors generally acknowledged to control inlet behavior. That is, the tidal discharge which acts to flush the inlet and, on the other hand, the intrusive littoral materials depositing in the inlet environment. Specifically, a "flow conveyance index" was computed and compared to shoreline movements. The "flow conveyance index" was defined as the ratio of the mean distribution of the overall planform area of the throat of the inlet to the mean distribution of the planform areas of shoals within the throat of the inlet. High and low "flow conveyance index" values would correspond, respectively, to periods of relatively high and low inlet flushing conditions. A consistent pattern obtained from this analysis, wherein high and low index values corresponded with high and low shoreline movements. Additionally, the plot of rates of shore movements against rates of change of "flow conveyance index" was fitted with a simple linear regression line having a positive correlation coefficient of 0.85. Further analyses of the mean distribution of the shoals within the throat of the inlet demonstrated the cause of timevarying rates of movement of points along the spiriferous east shoreline of the inlet. Shoreline movement rates were plotted on a time-space plane and isolines of shore movement rates contoured. The result was a three-dimensional image of shore movement rates over time and distance. The position of the centroid of the inlet shoal distribution at different times was superimposed upon the three-dimensional image. This revealed that variations of shoreline movement rates along the shore at any point in time are dependent on the mean position of the inlet shoal distribution. Also, the direction of movement of the mean position of the inlet shoal distribution appeared to indicate the predominant direction of flushing action, that is, flood or ebb tides.
Joseph Lister and the origins of antisepsis

In the mid-nineteenth century when Joseph Baron Lister was beginning his surgical career, bold new theories of medicine were being proposed with increasing frequency. Many of these new theories were in conflict as to how the body functioned and how disease and injury should be approached. They all conflicted more, however, with the older theory of vitalism which they were gradually replacing. Lister believed in vitalism and was quite bothered by the new theories, but did not react to them with hostile criticism or bombast. His typical gentlemanly style was to test them quietly against his own understandings and beliefs. This historical essay focuses upon the feelings, thoughts, and beliefs of Joseph Lister as reflected by his background and his most important experiments. It will show that the discovery which transformed surgery did not originate from any “leading edge” medical theory of the era. The antiseptic principle originated from the experimentation of a troubled vitalist in the service of the theory in which he so passionately believed.
Standardizing Methods of Measurement of Foot Shape by Including the Effects of Subtalar Rotation

At the present time, there is no easily performed method of measuring foot shape that can quantitatively differentiate types of feet. We studied 44 feet of individuals with normal appearing asymptomatic feet and flat symptomatic feet to find criteria for measurement of foot shape. We found that measurements of footprints are unreliable. Radiographic methods must include measurements in different positions, or at least specify the position of subtalar rotation to be meaningful, since the height of the arch can change just by rotating the tibia. Traditional measurements of talocalcaneal angles have no precision and are unreproducible.
Conflicting Administrative and Critical Paradigms in Data Tracking Policy: A Lazarsfeldian Analysis

In 1941, Paul Lazarsfeld wrote that administrative research in communications (of which he was a founding figure) is often criticized for addressing only “little problems, generally, of a business character…” while critical research can be criticized for focusing on dramatic high-level ideals and “showing up” those in power, but with a lack of “fact-finding or constructive suggestions.” This article considers Lazarsfeld’s conceptions to be a functional dichotomy, and then compares that dichotomy to a modern policy debate in telecommunications: personal data tracking by Internet firms and proposals in the American government for regulating it. This article will argue that the administrative/critical dichotomy can be observed in the contentions of industry leaders, consumer advocates, media commentators, and politicians who have contributed to this policy debate.
Randomized generalization for aggregate suppression over hidden web databases

Many web databases are hidden behind restrictive form-like interfaces which allow users to execute search queries over the underlying hidden database. While it is important to support such search queries, many hidden database owners also want to maintain a certain level of privacy for aggregate information over their databases, for reasons including business secrets and homeland security. Existing work on aggregate suppression thwarts the uniform random sampling of a hidden database, but cannot address recently proposed attacks which accurately estimate SUM and COUNT queries without the need to first draw a uniform random sample. In this paper, we consider the problem of suppressing SUM and COUNT queries over a hidden database. In particular, we develop randomized generalization, a novel technique which provides rigid aggregate-suppression guarantee while maintaining the utility of individual search queries. We present theoretical analysis and extensive experiments to illustrate the effectiveness of our approach.
Effects of the unemployment insurance work test on long-term employment outcomes

Abstract Does requiring job seekers to be available and searching for work affect job quality? We examine the effects of this unemployment insurance (UI) work test on long-term employment outcomes. Adding administrative wage records to the Washington Alternative Work Search (WAWS) experiment, we examine effects on earnings, hours worked, employment, and job match quality in the nine years following the experiment. Among UI recipients as a whole, the effects of the work test were negligible, counter to the hypothesis that the work test may harm long-term earnings. But for permanent job losers, the work test reduced time to reemployment by 1–2 quarters, and increased job tenure with the first post-claim employer by about 2 quarters. Also, we find that the work test selected lower-wage workers into reemployment. Accordingly, the work test may be an important policy for improving the reemployment prospects of lower-wage, permanent job losers.
Odorant receptors and desensitization proteins colocalize in mammalian sperm.

The identification of transcripts encoding putative olfactory receptors in mammalian germ cells (1) has generated the hypothesis that olfactory receptors may serve a chemosensory role in sperm Chemotaxis during fertilization. We have sought to identify and localize these receptors and their regulatory machinery in rat sperm in order to gain further insight into mammalian sperm Chemotaxis and odorant receptor physiology. We conducted reverse transcription-polymerase chain reaction (RT-PCR) using degenerate primers directed against sequences conserved across members of the known odorant receptor family to identify transcripts from testis and round spermatids. Western analysis and immunohistochemistry were performed using antibodies raised against two peptide sequences conserved among odorant receptors and using fusion protein antibodies to G-protein receptor kinase 3 (GRK3/βARK2) and β-arrestin2. We detected transcripts encoding putative odorant receptors in both testis and round spermatids of the adult rat. Restriction digests of the PCR products demonstrated the existence of multiple gene products. Two anti-odorant receptor antibodies specifically recognized a 64 kD band in rat sperm preparations by Western blot. The proteins GRK3 and β-arrestin2, implicated in olfactory desensitization, were detected in sperm cytosolic extracts using Western analysis. Immunohistochemistry colocalized putative odorant receptors, GRK3 and β-arrestin2 to elongating spermatids in the testis and to the midpiece of mature sperm.
Beating the Bank: Transnational Civil Society and the 10 th IDA

The World Bank has a large policy footprint. Lending billions of dollars annually to scores to countries, its work has implications for everything from global environmental policy to human rights. As a result, numerous TCSOs have sought to influence the Bank in areas where its policies impact their activities or objectives. During the IDA-10, the attention of many of these groups converged to focus on a single issue of funding.
Effect of Release of the First Pediatric Appropriate Use Criteria on Transthoracic Echocardiogram Ordering Practice

Pediatric appropriate use criteria (AUC) were recently published for initial outpatient transthoracic echocardiography (TTE). The purpose of this study was to determine the effect of AUC publication on TTE ordering patterns of pediatric cardiologists. Data were prospectively collected on patients who had initial outpatient TTE ordered before (phase I, April to September 2014) and 3 months after (phase II, January to April 2015) AUC document publication at 6 centers. Site investigators assessed each study's indication and assigned AUC appropriateness as "appropriate" (A), "may be appropriate" (M), "rarely appropriate" (R), or "unclassifiable." One hundred three physicians ordered 4,562 TTEs (2,655 phase I and 1,907 phase II). Overall, there was no statistically significant change in the proportion of A, M, or unclassifiable, but R decreased (12.0% to 9.6%, p = 0.01). There was significant variability among the centers in the percentage of studies for indications rated R (4.9% to 34.8%). There was no significant change in any of the appropriateness ratings at 4 centers, a decrease in R and an increase in A at 1 and a decrease in R and increase in unclassifiable at another. The first pediatric AUC document had only a small impact on physician ordering behavior for initial TTEs, including a small decrease in R. There was a significant variability in appropriateness of studies among centers. These data suggest that active educational interventions are required to substantially improve the appropriate use of pediatric TTE in the outpatient setting.
A COMPARISON OF THE BABCOCK, MOJONNIER, AND MILKO-TESTER MARK III METHODS IN THE ANALYSIS OF MILKFAT IN CREAM1

The Babcock, Mojonnier, and Milko-Tester Mark III methods of milkfat analyses were compared on creams ranging in milkfat from 6.6 to 50.0%. Variances (s2) of the three methods on 243, 246, and 336 observations, respectively, were 0.062, 0.048, and 0.017. Variability tended to increase with an increase in milkfat content of the creams. This was true for all three methods. Regression formulae for estimating Babcock and Mojonnier values from Milko-Tester values were, respectively, ŷ = −0.94795 + 1.06699 (X), and ŷ = −0.60222 + 1.04850 (X). Correlation coefficients for the Milko-Tester Mark III with the Babcock and Mojonnier methods were 0.9987 and 0.9983, respectively. These relationships were noted with the Milko-Tester unit calibrated on whole milk, and indicate the feasibility of Milko-Tester use on cream samples whether calibrated at lower milkfat levels and calculated from regression formulae, or calibrated at the approximate range of milkfat test expected and read directly.
Construction History of the Deason House, Jones County, Mississippi

The Deason House is located in the heart of the Piney Woods region in the town of Ellisville, Mississippi. During the American Civil War, the Deason House became the epicenter for an event that started a rebellion against the Confederate government. On 5 October 1863, a Confederate deserter named Newton Knight allegedly shot and killed Confederate Major Amos McLemore in the Deason House, which eventually lead to the formation of the Free State of Jones. Despite the historical importance of the house, oral accounts and written documents have failed to provide accurate construction history of the structure. We coupled techniques of dendrochronology and geophysical survey to better understand the construction history of the Deason House and cultural activities of its inhabitants. We extracted 35 Pinus palustris (Mill.) timbers along the west-facing exterior weatherboards and from various logs within the second-floor attic, 25 of which were successfully crossdated against a P. palustris reference chronology located 15 km south in De Soto National Forest (1742–2013). The Deason House chronology anchored against the De Soto time series during the period 1742–1875 (r = 0.55, t = 4.01, p < 0.0001) and extended the reference chronology back to the year 1680 CE. Clustering of cutting- and near-cutting dates from timbers revealed 3 possible stages of construction. First, the house likely existed as a single-pen structure built in the winter of 1835/1836, based on two timbers with wane/bark that were affixed to the original chimney made of clay bricks fired on the homestead. Second, based on the clustering of 1855 cutting dates, we suggest this was the most likely time the original structure was expanded with a vestibule, porch, and larger 4-room house. Finally, six timbers revealed a back addition was constructed in the year 1866. Ground penetrating radar (GPR) helped provide evidence mentioned in written records that the back addition (1866) existed as the detached kitchen then was affixed to the structure ca. 1890. The GPR data revealed geophysical anomalies that indicated the original sites of the detached kitchen, water well, livestock pen, privies, and trash pit. Through the use of dendrochronological analyses and geophysical survey, we were able to provide an updated history of the Deason House construction dynamics and cultural activities of its inhabitants beyond the historical record.
Design and Quality Control for Translating 3D-Printed Scaffolds

Abstract 3D printing has become widely utilized for regenerative medicine research due to its ability to fabricate patient-specific scaffolds with well-controlled porous architecture and the capability of printing cells in 3D configurations. These characteristics, combined with the unique capability of producing implants and scaffolds for small, specific patient populations not feasible with other manufacturing techniques, have generated significant interest in using 3D printing to transplant implants and scaffolds for clinical use. However, like any clinically translated device, 3D printed scaffolds are subject to design control and quality control requirements to achieve regulatory approval. 3D printing, with its ability to make patient-specific and custom scaffolds; however, brings a number of challenges for design and quality control. In this chapter, we present an example design and quality control for a laser-sintered 3D-printed, resorbable polycaprolactone splint to treat tracheobronchalmalacia (TBM). This splint has been used clinically to save three children with life threatening TBM. We specifically describe a design control for the PCL resorbable splint, detailing design requirements for surgical, mechanical, and biomaterial needs of the splint. Design control entails not only the design requirements for the device, but also the tests to verify that the final device meets the design inputs (design verification) and the preclinical and clinical tests to verify that the fabricated device meets the clinical requirements (design validation). Finally, since design verification and validation are dependent on the laser sintering fabrication process, we detail the parameters of the laser sintering process as well as the methods used to assess devices made using the laser sintering process.
Analyzing user interactions with biomedical ontologies

Biomedical ontologies are large: Several ontologies in the BioPortal repository contain thousands or even hundreds of thousands of entities. The development and maintenance of such large ontologies is difficult. To support ontology authors and repository developers in their work, it is crucial to improve our understanding of how these ontologies are explored, queried, reused, and used in downstream applications by biomedical researchers. We present an exploratory empirical analysis of user activities in the BioPortal ontology repository by analyzing BioPortal interaction logs across different access modes over several years. We investigate how users of BioPortal query and search for ontologies and their classes, how they explore the ontologies, and how they reuse classes from different ontologies. Additionally, through three real-world scenarios, we not only analyze the usage of ontologies for annotation tasks but also compare it to the browsing and querying behaviors of BioPortal users. For our investigation, we use several different visualization techniques. To inspect large amounts of interaction, reuse, and real-world usage data at a glance, we make use of and extend PolygOnto, a visualization method that has been successfully used to analyze reuse of ontologies in previous work. Our results show that exploration, query, reuse, and actual usage behaviors rarely align, suggesting that different users tend to explore, query and use different parts of an ontology. Finally, we highlight and discuss differences and commonalities among users of BioPortal.
Is bigger better? Driving factors of POTW performance in New York.

Abstract Like many regions around the world, New York State, USA, faces challenges in meeting wastewater treatment quality standards because of aging infrastructure, limited funding, shifting demographics and increasingly stringent environmental regulations. In recent decades construction of new wastewater treatment and distribution infrastructure in NY has most often occurred in exurban communities and suburban developments that are less dense than traditional urban cores. Here, we examine the role of size and capacity utilization on wastewater treatment effectiveness with respect to critical effluent parameters, and additionally explore which common facility engineering controls influence water quality treatment using a unique dataset of descriptive information. Our results challenge conventional wisdom, suggesting that the largest facilities (>30,000 m 3 /d), not the smallest ( 3 /d), discharge TSS, BOD, and coliform at significantly higher relative effluent concentrations (i.e., the ratio of discharged concentrations to allowable limits). Capacity utilization was also positively correlated to higher concentrations of TSS, BOD, and coliform effluent concentrations in larger facilities, though those concentrations were often within regulated limits. This implies that smaller-sized facilities may perform better in terms of environmental quality, but that the largest facilities demonstrate efficiency in the sense that they are not “over-treating” wastewater while avoiding violations. Results from NY suggest that medium sized facilities (300–30,000 m 3 /d) are sophisticated enough to incorporate appropriate unit processes, and employ operators with sufficient training and oversight, to reach treatment outcomes that are both reliable and of high quality.
Analysis of the effects of EHR implementation on timeliness of care in a dermatology clinic: a simulation study.

Objective Quantify the downstream impact on patient wait times and overall length of stay due to small increases in encounter times caused by the implementation of a new electronic health record (EHR) system. Methods A discrete-event simulation model was created to examine the effects of increasing the provider-patient encounter time by 1, 2, 5, or 10 min, due to an increase in in-room documentation as part of an EHR implementation. Simulation parameters were constructed from an analysis of 52 000 visits from a scheduling database and direct observation of 93 randomly selected patients to collect all the steps involved in an outpatient dermatology patient care visit. Results Analysis of the simulation results demonstrates that for a clinic session with an average booking appointment length of 15 min, the addition of 1, 2, 5, and 10 min for in-room physician documentation with an EHR system would result in a 5.2 (22%), 9.8 (41%), 31.8 (136%), and 87.2 (373%) minute increase in average patient wait time, and a 6.2 (12%), 11.7 (23%), 36.7 (73%), and 96.9 (193%) minute increase in length of stay, respectively. To offset the additional 1, 2, 5, or 10 min, patient volume would need to decrease by 10%, 20%, 40%, and >50%, respectively. Conclusions Small changes to processes, such as the addition of a few minutes of extra documentation time in the exam room, can cause significant delays in the timeliness of patient care. Simulation models can assist in quantifying the downstream effects and help analyze the impact of these operational changes.
Chemical Systematics of Iron-57 Hyperfine Magnetic Field Distributions in Iron Alloys

There have been several excellent reviews of applications of iron-57 Mossbauer spectrometry in physical metallurgy and metals physics.1–9 These reviews typically demonstrate applications of the four measurable quantities in Mossbauer spectroscopy: recoil-free fraction, isomer shift, quadrupole effect, and hyperfine magnetic field (HMF). The present chapter has a more focused goal. It shows how local, short-range chemical information can be obtained from the HMF distribution of iron-57 nuclei in ferromagnetic bcc alloys.
Anastomotic Strictures Following Radical Prostatectomy: Risk Factors and Management

Stricture of the anastomosis between the bladder neck and membranous urethra after radical prostatectomy can cause significant voiding dysfunction. Of 156 patients undergoing radical prostatectomy for localized prostatic carcinoma 18 had anastomotic stricture for an over-all incidence of 11.5%. The risk factors for anastomotic stricture and the treatment outcome in these patients were analyzed. Excessive intraoperative blood loss, extravasation of urine at the anastomotic site and a prior transurethral prostatic operation significantly contributed to the development of stricture. More than half of the patients did not respond to simple dilation alone. Cold knife incision of the stricture by itself was effective in only 62% of the patients. The remaining patients required periodic dilation to maintain an adequate urine flow. Incision of the stricture with electrocautery resulted in urinary incontinence in all patients.
Teaching safety skills to children: prevention of firearm injury as an exemplar of best practice in assessment, training, and generalization of safety skills

The focus of this paper is on teaching safety skills to children with an emphasis on recent research on behavioral skills training for the prevention of firearm injury. Following a discussion of safety skills and methods for assessing these skills, the paper reviews recent research on behavioral skills training and in situ training for teaching safety skills to prevent firearm injury. Strategies for promoting generalization and increasing the efficiency of training are then discussed, along with a summary of conclusions that can be drawn from the research and guidelines for best practices in teaching safety skills to children.
Analytical Method to Determine Transportation Service Gaps for Transportation Disadvantaged Populations

Transportation disadvantaged (TD) populations, which include elderly people, people with disabilities, and people who do not own a vehicle, face mobility challenges because alternative transportati...
An Integrative Review on Teen Distracted Driving for Model Program Development

Distracted driving, especially driver inattention, is associated with high levels of crash-related fatalities and injury. Teen novice drivers are one of the groups most likely to drive distracted and to suffer its consequences. Teens have a higher risk of engaging in texting or secondary tasks, e.g., eating while driving. Distracted driving interventions to date aim to improve teen and societal safety, but few have achieved effectiveness. A need exists for effective evidence-based distracted driving interventions. We used an integrative review to identify rigorous evidence, and inform the development of a teen distracted driving educational intervention. This five-step review included: identifying the research problem; collecting literature; evaluating literature; synthesizing data; and presenting results. We searched 6 databases, identifying 185 articles. Following three rounds of inclusion screening (title, abstract, and full-text), captured according to a PRISMA flow chart, 17 studies met inclusion. We categorized these studies, conducted in the U.S., as five intervention types that used approaches including presentations, videos or instructional programs, education or training programs, driving simulator training, in-vehicle monitoring or feedback, and integrated programs. Study designs included randomized controlled trials pre-post, quasi-experimental, and experimental designs with prospective longitudinal cohorts. The studies were heterogeneous in design, intervention and outcome. However, three core themes emerged across studies: i.e., hazard awareness, hazard mitigation and attention maintenance are primary critically necessary skills to prevent distracted driving; engaging a parent or adult as a partner in the intervention process from classroom to car contributed to the effectiveness of the intervention; and leveraging technology in training enhanced the effectiveness of the intervention. Study limitations pertained to a focus on short-term effects; sampling distributions that did not account for gender, age, race, and/or ethnicity; types of interventions; and bias. The limitations affect the generalizability of included study findings and, potentially, the review findings, as they may not apply to populations or contexts outside those synopsized. Strengths included our team's expertise in conducting evidence-based reviews, support of a health science librarian, and use of international review guidelines. As an outcome, we are applying findings of the integrated review to develop a computer-based training addressing teen distracted driving.
Field results from point to point real-time underwater acoustic tracking using a simple mathematical filter

MBARI has developed and field tested a simple real time single beacon acoustic underwater asset tracking algorithm using range and bearing data only. A Benthos USBL DAT mounted in a Liquid Robotics Wave Glider surface vehicle successfully tracked an underwater drifting Coastal Profiling Float and a moving Long Range Autonomous Underwater Vehicle, both of which were outfitted with Benthos acoustic modems, for up to four days. The algorithm uses an error function weighted moving average to filter range data combined with simultaneous bearing data to provide the Wave Glider with updated underwater position estimates. Successful field trials were conducted off Monterey, CA and Hawaii with results presented in this paper. The algorithm operates in real time and requires very low computational overhead.
Streamlined Asymmetric Reaction Development: A Case Study with Isatins.

Asymmetric reaction development within a day or two has been a dream of synthetic chemists for several decades. We now show that such a task is feasible with a highly efficient streamlined screening strategy using the asymmetric allylation of isatins with a chiral boron complex as a case study. Our high-throughput screening (HTS) method is based on fast optical UV/CD analysis of minute amounts of crude reaction mixtures (≈3 mg scale) and it obviates product isolation and the general need for reference compounds which greatly reduces preliminary work and analysis time. The setup, reaction screening, analysis and data processing for 54 asymmetric allylations of nine different isatins in six different solvents was handled by a single operator in less than 20 work hours. One could easily extend this HTS strategy to hundreds of reactions in roughly the same time frame and further reduce the labor with commercially available automated high-throughput experimentation equipment. The effectiveness of this asymmetric reaction development strategy is confirmed with the upscale synthesis of two representative 3-allyl-3-hydroxyisatins in 98-99 % yield and with 91-94 % ee under optimized conditions.
Imaging CTLA-4+ T-cells in humanized mouse models

2 Objectives: Checkpoint immunotherapy treatments are showing great promise for cancer patients; however, the mechanisms and predictors of response are still largely mysteries, especially for CTLA-4-targeted treatments, which have particularly heterogeneous response patterns. Imaging of these immunotherapy targets using positron emission tomography (PET) can allow for noninvasive monitoring of their dynamic expression and biodistribution, and may allow for patient stratification in the future. Therefore, two tracers targeting human CTLA-4, one a full antibody and the other a F(ab’)2 fragment, were radiolabeled with 64Cu and validated in humanized mouse models. Methods: Ipilimumab was enzymatically digested to develop ipilimumab-F(ab’)2, and both the intact antibody and the fragment were conjugated with NOTA to chelate 64Cu for PET. Both tracers maintained their specificity for activated CTLA-4+ T-cells in vitro. The tracers were administered to both control NBSGW mice and humanized mice (PBL mice, which were engrafted with human peripheral blood lymphocytes), and PET was conducted out to 48 h post-injection. The onset of graft-versus-host disease in these humanized mice causes their salivary glands to dysfunction and sequestration of the foreign cells there, providing a localized site for exploration of CTLA-4+ tissue uptake. PET region-of-interest analysis, ex vivo biodistribution studies, and tissue staining were used to confirm that the tracers specifically accumulated in CTLA-4+ tissues. Results: Following intravenous injection of the respective tracers (n=3-5 per group), specific uptake was noted in the salivary gland tissues of the humanized mice. This uptake, as a result of graft-versus-host disease onset, was proven to be due to the presence of human T-cells through staining of the tissues for human CD3 and CTLA-4. 64Cu-NOTA-ipilimumab demonstrated the highest absolute uptake in the salivary glands of PBL mice, peaking at 7.00 ± 2.19 %ID/g, 24 h post-injection. In contrast, 64Cu-NOTA-ipilimumab-F(ab’)2 uptake was at 2.40 ± 0.86 %ID/g at the same time point. However, the F(ab’)2 agent cleared from circulation much more quickly than the intact antibody, providing higher salivary gland-to-blood ratios, which reached 1.78 ± 0.72 at 48 h post-injection, compared to 64Cu-NOTA-ipilimumab at 1.19 ± 0.49. Comparison with a nonspecific IgG, with a salivary gland-to-blood ratio of only 0.34 ± 0.08, verified the specificity of the salivary gland uptake with the targeted tracers. Uptake of the tracers in the salivary glands of control mice, and the nonspecific tracer in the PBL mice, was lower than that of the related targeted tracers at all imaging time points. Ex vivo studies verified all the trends found through PET analysis. Conclusions: PET imaging with both 64Cu-NOTA-ipilimumab and 64Cu-NOTA-ipilimumab-F(ab’)2 was able to localize CTLA-4+ tissues. These tracers may thus help elucidate the mechanisms of response to, and possibly toxicity from, CTLA-4-targeted checkpoint immunotherapy treatments.
Ligand binding characteristics of the Ku80 von Willebrand domain.

Abstract The N-terminal von Willebrand domain of Ku80 supports interactions with a Ku binding motif (KBM) that has been identified in at least three other DNA repair proteins: the non-homologous end joining (NHEJ) scaffold APLF, the modulator of retrovirus infection, MRI, and the Werner syndrome protein (WRN). A second, more recently identified Ku binding motif present in XLF and several other proteins (KBMX) has also been reported to interact with this domain. The isolated Ku80 von Willebrand antigen domain (vWA) from Xenopus laevis has a sequence that is 60% identical with the human domain, is readily expressed and has been used to investigate these interactions. Structural characterization of the complexes formed with the KBM motifs in human APLF, MRI, and WRN identify a conserved binding site that is consistent with previously-reported mutational studies. In contrast with the KBM binding site, structural studies indicate that the KBMX site is occluded by a distorted helix. Fluorescence polarization and 19F NMR studies of a fluorinated XLF C-terminal peptide failed to indicate any interaction with the frog vWA. It was hypothesized that availability of this binding site is conditional, i.e., dependent on specific experimental conditions or other repair factors to make the site available for binding. Modulating the fraction of KBMX-accessible binding site mutationally demonstrated that the more open site is capable of binding the KBMXXLF motif peptide. It is suggested that the conditional nature of KBMX binding limits formation of non-productive complexes so that activation-dependent site availability can more optimally support advancing the synapsis process.
Patterns of palliative care among patients receiving palliative radiotherapy.

55Background: Few studies have examined how palliative care (PC) delivered by a dedicated PC team is integrated at the time of radiotherapy (RT) consultation. We aimed to characterize patterns of P...
Uninterrupted continuous glucose monitoring access is associated with a decrease in HbA1c in youth with type 1 diabetes and public insurance.

Objective Continuous glucose monitor (CGM) use is associated with improved glucose control. We describe the effect of continued and interrupted CGM use on hemoglobin A1c (HbA1c) in youth with public insurance. Methods We reviewed 956 visits from 264 youth with type 1 diabetes (T1D) and public insurance. Demographic data, HbA1c and two-week CGM data were collected. Youth were classified as never user, consistent user, insurance discontinuer, and self-discontinuer. Visits were categorized as never-user visit, visit before CGM start, visit after CGM start, visit with continued CGM use, visit with initial loss of CGM, visit with continued loss of CGM, and visit where CGM is regained after loss. Multivariate regression adjusting for age, sex, race, diabetes duration, initial HbA1c, and BMI were used to calculate adjusted mean and delta HbA1c. Results Adjusted mean HbA1c was lowest for the consistent user group (HbA1c 8.6%;[95%CI 7.9,9.3]). Delta HbA1c (calculated from visit before CGM start) was lower for visit after CGM start (-0.39%;[95%CI -0.78,-0.02]) and visit with continued CGM use (-0.29%;[95%CI -0.61,0.02]) whereas it was higher for visit with initial loss of CGM (0.40%;[95%CI -0.06,0.86]), visit with continued loss of CGM (0.46%;[95%CI 0.06,0.85]), and visit where CGM is regained after loss (0.57%;[95%CI 0.06,1.10]). Conclusions Youth with public insurance using CGM have improved HbA1c, but only when CGM use is uninterrupted. Interruptions in use, primarily due to gaps in insurance coverage of CGM, were associated with increased HbA1c. These data support both initial and ongoing coverage of CGM for youth with T1D and public insurance. This article is protected by copyright. All rights reserved.
A public health approach for prevention of periodontal disease

Upwards of 1 in 10 adults worldwide may be affected by severe periodontitis, making the disease more prevalent than cardiovascular disease. Despite its global scope, its impact on pain, oral function, and the wellbeing of individuals, and the disproportionate burden of disease and the socioeconomic impact on communities, the perception that periodontal disease is a public health problem remains low. Although there have been substantial improvements in our understanding of the etiology of periodontal disease and how we can prevent and control it, these advances have been primarily focused on individual, patient-focused approaches. The prevention of periodontal disease depends on improving currently available individual interventions and on determining what public health interventions can be effective and sustainable under real-life conditions. Currently, public health approaches for periodontal disease prevention and control are lacking. This review traces the historical strategies for prevention of periodontal disease in an epidemiologic transition context, using a modified model developed for cardiovascular disease, and presents a possible public health approach. Improving periodontal disease prevention and control will need to take into consideration the core activities of a public health approach: assessment, policy development, and assurance.
Artifacts and artifact removal in optical coherence tomographic angiography

Optical coherence tomographic angiography (OCTA) enables rapid imaging of retinal vasculature in three dimensions. While the technique has provided quantification of healthy vessels as well as pathology in several diseases, it is not unusual for OCTA data to contain artifacts that may influence measurement outcomes or defy image interpretation. In this review, we discuss the sources of several OCTA artifacts-including projection, motion, and signal reduction-as well as strategies for their removal. Artifact compensation can improve the accuracy of OCTA measurements, and the most effective use of the technology will incorporate hardware and software that can perform such correction.