cssi/SciSciGPT-SciSciNet huggingface dataset:
Nodal immune flare mimics nodal disease progression following neoadjuvant immune checkpoint inhibitors in non-small cell lung cancer.

Radiographic imaging is the standard approach for evaluating the disease involvement of lymph nodes in patients with operable NSCLC although the impact of neoadjuvant immune checkpoint inhibitors (ICIs) on lymph nodes has not yet been characterized. Herein, we present an ad hoc analysis of the NEOSTAR trial (NCT03158129) where we observed a phenomenon we refer to as “nodal immune flare” (NIF) in which patients treated with neoadjuvant ICIs demonstrate radiologically abnormal nodes post-therapy that upon pathological evaluation are devoid of cancer and demonstrate de novo non-caseating granulomas. Abnormal lymph nodes are analyzed by computed tomography and 18F-fluorodeoxyglucose positron emission tomography/computer tomography to evaluate the size and the maximum standard uptake value post- and pre-therapy in NEOSTAR and an independent neoadjuvant chemotherapy cohort. NIF occurs in 16% (7/44) of patients treated with ICIs but in 0% (0/28) of patients after neoadjuvant chemotherapy. NIF is associated with an inflamed nodal immune microenvironment and with fecal abundance of genera belonging to the family Coriobacteriaceae of phylum Actinobacteria, but not with tumor responses or treatment-related toxicity. Our findings suggest that this apparent radiological cancer progression in lymph nodes may occur due to an inflammatory response after neoadjuvant immunotherapy, and such cases should be evaluated by pathological examination to distinguish NIF from true nodal progression and to ensure appropriate clinical treatment planning. Granulomatous/sarcoid-like lesions have been reported in patients treated with immune checkpoint inhibitors (ICIs). Here the authors report the occurrence of “nodal immune flare”, an apparent radiological cancer progression in the nodes characterized by the absence of cancer and the presence of non-caseating granulomas, in patients with non-small cell lung cancer following neoadjuvant ICI treatment.
Free School Meals and Demand for Community Food Resources

Many community organizations provide services similar to government income assistance programs but there is little empirical evidence on how these systems interact. We examine how greater access to government nutritional aid through free school meals affects local food bank utilization by leveraging variation in the timing of schoolwide free meal programs and administrative data from largest food bank network in the United States. We find that increasing access to free meals by 10 percentage points reduces food bank use by about 0.5 percent, and up to 1 percent in areas where relatively few students previously qualified for free meals.
Preventing and Correcting Mistakes in Lifelong Mapping

A Graph SLAM system is only as good as the edges in its pose graph. Critical mistakes in the generation of these edges can instantly render a map inconsistent, misleading, and ultimately unusable. For a lifelong mapping system, where the map is updated continuously, avoiding these errors altogether is infeasible. Instead, we propose a system for detection of and recovery from severe errors in edge generation. Our system remedies both edges created by view observations and edges created by an odometry motion model. For observation edges, we pair a novel method for monitoring ambiguous views with an intelligent graph-merging algorithm capable of rejecting a relocalization in progress. For motion edges, we propose a qualitative geometric approach for detecting structural aberrations characteristic of odometry failures. We conclude with an analysis of our results based on an empirical study of thousands of robot runs.
Dissipative Quantum Transport in Electron Waveguides

Recent advancements in film growth and patterning have made possible the fabrication of “electron waveguides,” in which transport is analogous to ordinary microwave waveguides. In the past, such devices have been analyzed by assuming that transport is dissipationless, so that the overall transmission between contacts can be computed using the Schrodinger equation. Any device operated at realistic bias levels and temperatures, however, will be influenced by dissipative scattering. Recently, a steady-state quantum kinetic equation has been developed based on a simple model for dissipative processes. In the limit of linear response, this equation can be formulated in terms of a local chemical potential. We use this model to investigate how the chemical potential and current flow pattern are disturbed when a voltage probe is attached to a structure. We show that voltage which is finally measured by the probe is a weighted average of the chemical potential everywhere within a phase-breaking length of the probe junction. Further application of this model to 2-dimensional structures will clarify how to best design a potential probe so that it measures a local quantity.
Discussion of construal instructions and professional skepticism in evaluating complex estimates

Prior auditing research and PCAOB inspection reports note that auditors have difficulty auditing complex accounting estimates. Rasso (2015) tests whether providing auditors with documentation instructions “based on the precepts of construal-level theory (CLT)” improves auditor effectiveness and skepticism when auditing these types of estimates. In this discussion, we highlight some comments about Rasso’s study from participants at the Accounting, Organizations and Society Conference on Accounting Estimates and share our own perspectives about the study’s conclusions and implications for research and practice.
Clinical Outcomes for Peripartum Cardiomyopathy in North America Results of the IPAC Study (Investigations of Pregnancy-Associated Cardiomyopathy)

Abstract Background Peripartum cardiomyopathy (PPCM) remains a major cause of maternal morbidity and mortality. Objectives This study sought to prospectively evaluate recovery of the left ventricular ejection fraction (LVEF) and clinical outcomes in the multicenter IPAC (Investigations of Pregnancy Associated Cardiomyopathy) study. Methods We enrolled and followed 100 women with PPCM through 1 year post-partum. The LVEF was assessed by echocardiography at baseline and at 2, 6, and 12 months post-partum. Survival free from major cardiovascular events (death, transplantation, or left ventricular [LV] assist device) was determined. Predictors of outcome, particularly race, parameters of LV dysfunction (LVEF), and remodeling (left ventricular end-diastolic diameter [LVEDD]) at presentation, were assessed by univariate and multivariate analyses. Results The cohort was 30% black, 65% white, 5% other; the mean patient age was 30 ± 6 years; and 88% were receiving beta-blockers and 81% angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. The LVEF at study entry was 0.35 ± 0.10, 0.51 ± 0.11 at 6 months, and 0.53 ± 0.10 at 12 months. By 1 year, 13% had experienced major events or had persistent severe cardiomyopathy with an LVEF Conclusions In a prospective cohort with PPCM, most women recovered; however, 13% had major events or persistent severe cardiomyopathy. Black women had more LV dysfunction at presentation and at 6 and 12 months post-partum. Severe LV dysfunction and greater remodeling at study entry were associated with less recovery. (Investigations of Pregnancy Associated Cardiomyopathy [IPAC]; NCT01085955 )
RBF-based receding horizon control approach to personalized anemia treatment

A receding horizon controller is proposed as a means to personalize anemia management in hemodialysis patients. The proposed method is an optimization-based control approach in which a radial basis function (RBF) method is used to design a receding horizon strategy for optimal dosing of anemia drug, erythropoietin (EPO). The in silico validation of the method demonstrates its efficiency when compared to a standard protocol-based EPO dosing.
Velocity and the variability of money growth: Some international evidence

Abstract Using data from four countries, the paper tests Friedman's hypothesis that the volatility of money growth causes velocity to change. Despite a wide variety of patterns in the movements of velocity in these countries, support is evident for the hypothesis.
Adoption of Interorganizational Business Process Standards in Business-to-Business Integration: An Exploratory Study

We conducted an exploratory study to understand the factors that played important role in the adoption of RosettaNet-based interorganizational business process standards (IBPS) in business-to-business integration (B2Bi). We found 3 sets of drivers of IBPS adoption in organizations: i.e., external, internal, and instrumental. External factors include institutional pressures, standards uncertainty, and quality of interorganizational relationships. Internal factors include internal pressures, job change, technology readiness, ICT competence, and organizational culture. Finally, instrumental factors include perceived benefits, process compatibility, and complexity.
Radiation shielding for TFTR D-T operation

Deuterium-tritium (D-T) operation of the Tokamak Fusion Test Reactor (TFTR) machine will require extensive radiation shielding to satisfy biological as well as equipment operating objectives. Shielding design objectives include limiting the radiation dose rate at the site boundary to a prescribed level and limiting the neutron and gamma flux to levels which minimize electrical noise in diagnostic equipment and avoid damage to electrical components. The design and engineering approach taken to provide the shielding necessary to meet these objectives is discussed. The final shielding configuration, which includes the close-fitting machine igloo and the ancillary equipment enclosures, is presented; material types and component dimensions are identified. The design and installation schedule developed to assure the timely and efficient installation of the shielding is discussed. >
Optimal control of hereditary differential inclusions

Deals with optimal control problems for dynamical systems governed by constrained hereditary differential inclusions. We pay main attention to hereditary systems of the so-called neutral type, which contain time-delays in velocity variables along with delays in state coordinates. To the best of our knowledge, such problems for hereditary differential inclusions have not been considered in the literature. We construct well-posed discrete approximations of the continuous-time problem by a sequence of discrete-time problems, which can be treated by means of powerful tools of modern variational analysis and generalized differentiation. In this way we justify stability of discrete approximations and derive necessary optimality conditions for hereditary inclusions with both convex and nonconvex velocity sets in extended Euler-Lagrange and Hamiltonian forms; the latter one just for the convex case. Our results are expressed in terms of nonconvex sets of generalized normals, subgradients, and coderivatives for nonsmooth sets, functions, and set-valued mappings.
Gating of Hippocampal-Evoked Activity in Prefrontal Cortical Neurons by Inputs from the Mediodorsal Thalamus and Ventral Tegmental Area

Projections from the hippocampus, the mediodorsal thalamus (MD), and the ventral tegmental area (VTA) form interconnected neural circuits that converge in the prefrontal cortex (PFC) to participate in the regulation of executive functions. The present study assessed the roles that the MD and VTA play in regulating the hippocampal–PFC pathway using extracellular single-unit recordings in urethane-anesthetized rats. MD stimulation inhibited PFC neuron firing (∼100 msec duration) evoked by fimbria/fornix (FF) stimulation in a majority of neurons tested. However, this effect was reduced if activation of thalamocortical inputs occurred almost simultaneously (10 msec) with stimulation of the FF. In a separate population of neurons, burst stimulation of the MD produced a short-term (∼100 msec) inhibition or facilitation of FF-evoked firing in 66 and 33% of PFC neurons, respectively. Moreover, tetanic stimulation of the MD caused a longer-lasting (∼5 min) potentiation of FF-evoked firing. Burst stimulation of the VTA inhibited FF-evoked firing in a frequency-dependent manner: firing evoked by higher-frequency trains of pulses to the FF was less inhibited than firing evoked by single-pulse stimulation. The inhibitory actions of VTA stimulation were augmented by D1 receptor antagonism and attenuated by D2and D4 antagonists. Moreover, stimulation of the MD 10 msec before stimulation of the FF attenuated the VTA-mediated inhibition of evoked firing. Thus, both the MD and VTA exert a complex gating action over PFC neural activity, either facilitating or inhibiting firing in the hippocampal–PFC pathway depending on the frequency and relative timing of the arrival of afferent input.
On the decay rate of order-parameter fluctuations

Abstract We study the effect of non-Ornstein-Zernike behavior of the density-density correlation function on the decay rate of the order-parameter fluctuations in the mode-mode theory of Kawasaki and the decoupled-mode theory of Ferrell. In particular the Fisher-Langer form for the density-density correlation function is used to study the modification of the decay rate in the non-hydrodynamic regime.
The hydrolytic products of fetuin

Abstract The hydrolytic products of the fetuin fraction of fetal calf scrum, which is active in causing glass attachment and reproduction of mammalian cells, have been determined. The absence of methionine is noteworthy. Fetuin which has lost its biological activity as a result of chromatography on DEAE-cellulose columns, displays little or no change in its hydrolytic products. The hydrolytic products of another glycoprotein, orosomucoid, are also presented. The various possible relationships between the biological activity and the molecular constitution of the fetuin fraction are discussed.
Microstructure and strength development of beta-dicalcium silicate pastes with and without admixtures

Abstract Microstructural developmentin hydrating beta -dicalcium silicate pastes was studied up to 188 days using scanning electron microscopy. The overall development is similar to that observed previously for tricalcium silicate pastes, but some unusual features were observed and are described. The calcium silicate hydrate, Type I, is larger and better developed than that which is formed in tricalcium silicate pastes; and, moreover, calcium hydroxide also forms larger crystals. Tensile strength development follows the same relationship to gel-space ratio found for tricalcium silicate pastes, and is unaffected by the presence of admixtures. Chloride and carbonate salts promote the formation of Type II calcium silicate hydrate.
Locoregional management of hepatic metastasis from primary uveal melanoma

Uveal melanoma is the most common primary ocular malignancy in adults and has a significant predilection for metastasis to the liver. Despite successful treatment of the primary uveal melanoma, up to 50% of patients will subsequently develop a systemic metastasis, with the liver involved in up to 90% of these individuals. Metastatic uveal melanoma has proven to be resistant to currently available systemic chemotherapies. Recognition of the poor prognosis associated with liver metastasis has led to the evaluation of various locoregional treatment modalities primarily designed to control tumor progression in the liver, including surgical resection, hepatic arterial chemotherapy, transarterial chemoembolization (TACE), immunoembolization, radiosphere, drug-eluting beads, isolated hepatic perfusion (IHP), and percutaneous hepatic perfusion. This article reviews the efficacies, and morbidities of currently available locoregional therapies.
Analysis of proteolytic processes and enzymatic activities in the generation of huntingtin n-terminal fragments in an HEK293 cell model.

Background: N-terminal fragments of mutant huntingtin (htt) that terminate between residues 90–115, termed cleavage product A or 1 (cp-A/1), form intracellular and intranuclear inclusion bodies in the brains of patients with Huntington’s disease (HD). These fragments appear to be proteolytic products of the full-length protein. Here, we use an HEK293 cell culture model to investigate huntingtin proteolytic processing; previous studies of these cells have demonstrated cleavage of htt to cp-A/1 like htt fragments. Results: Recombinant N-terminal htt fragments, terminating at residue 171 (also referred to as cp-B/2 like), were efficiently cleaved to produce cp-A/1 whereas fragments representing endogenous caspase, calpain, and metalloproteinase cleavage products, terminating between residues 400–600, were inefficiently cleaved. Using cysteine-labeling techniques and antibody binding mapping, we localized the C-terminus of the cp-A/1 fragments produced by HEK293 cells to sequences minimally limited by cysteine 105 and an antibody epitope composed of residues 115–124. A combination of genetic and pharmacologic approaches to inhibit potential proteases, including c-secretase and calpain, proved ineffective in preventing production of cp-A/1. Conclusions: Our findings indicate that HEK293 cells express a protease that is capable of efficiently cleaving cp-B/2 like fragments of htt with normal or expanded glutamine repeats. For reasons that remain unclear, this protease cleaves longer htt fragments, with normal or expanded glutamine expansions, much less efficiently. The protease in HEK293 cells that is capable of generating a cp-A/1 like htt fragment may be a novel protease with a high preference for a cp-B/2-like htt fragment as substrate.
K-Ar ages of some volcanic rocks from the Cook and Austral Islands

K-Ar age measurements on 19 volcanic rocks from Rurutu, Mangaia, Rarotonga, and Aitutaki in the Cook-Austral chain do not show a systematic increase in the age of the volcanoes to the west-northwest away from Macdonald Seamount as predicted by the melting-spot hypothesis and suggested by geomorphic evidence. Ages determined for alkalic basalt samples from Rurutu range from 1.02 to 1.09 m.y., for Mangaia from 16.6 to 18.9 m.y., and for Aitutaki from 0.66 to 0.77 m.y. Two distinct periods of volcanism on Rarotonga were dated at 1.8 and 1.2 m.y. B.P. The relation between the dated units and the main shield-building stage of these volcanoes is uncertain and will remain so until better data on the eruption history and mode of formation of volcanoes in the chain are available.
Some Comments on “Community Psychiatry and Social Power”

that based upon information about harmful consequences of the ideas and services of community psychiatry. The article by Dr. Leifer does not fall into this category, but is apparently founded on ethical and political misgivings, and upon expectations of doom linked to a fear of governmental encroachment on the rights of individuals. Nevertheless, its arguments must be soberly considered because, even though not based upon fact, they may be useful in helping us clarify and guard against possible difficulties. Dr. Leifer's first fear is that com-
Antialiasing Filters for Coupled Reynolds-Averaged/Large-Eddy Simulations

The increasing complexity of engineering problems makes the coupling of multiple simulation codes attractive. In fluid mechanical applications, the physical range of flow phenomena that can be modeled can be extended significantly by coupling flow solvers based on the Reynolds-averaged Navier‐Stokes (RANS) approach and on large-eddy simulations (LES). These separate flow solvers run simultaneously and exchange information at the interface. However, because the LES flow solver operates usually with a much smaller time step, the LES data have to be sampled to provide data for the RANS flow solver. In the sampling process, aliasing errors can occur. Possibilities are investigated to suppress aliasing errors while preserving the amplitude and phase of the long wave spectrum.
A PDA platform for offline processing and streaming of stimuli for cochlear implant research

A PDA-based research platform has been developed for implementing novel speech processing strategies and conducting psychophysical experiments with cochlear implant (CI) research that do not necessarily require real-time processing. The developed interface streams stimuli pulses to a CI unit in an offline mode from a Personal Computer via PDA platform using Windows Sockets (WINSOCK). Front-end of the application is run in MATLAB where stimuli pulses are created. Winsock establishes a TCP/IP connection with the PDA and starts the transmission of stimuli data. Server application installed on the PDA reads the stimulation data and forwards it to the SDIO board in packets where it is forwarded to the cochlear implant unit and pulses are then played in realtime. Versatility and flexibility are the key characteristics of the platform for easy implementation and testing of a wide range of applications and experiments without advanced programming skills.
Love as a Starting Point for Pastoral Theological Reflection

This article draws on recent work in the theology of love to propose steps toward the development of a pastoral theology of love in order to inform the practice of pastoral care. A pastoral theology of love is a necessary foundation for an ecclesial practice of pastoral care that promotes growth in love. The article defines love and addresses key issues in the theology of love, namely, human agency and the analogies that exist or do not exist between human and divine love and the concept of growth in love, or sanctification. The article concludes by proposing and sketching some key features of a pastoral theology of love for pastoral practice.
Thermic diode solar panels for space heating

Abstract Thermic diode solar panels are a new method of heating buildings using solar energy. Each panel combines all the necessary elements of a complete solar energy system (collector, controls, storage heat exchangers and ducting) into a single module. They have no moving parts and they need no external power. Panal operation is discussed and thermic panels are compared to other typical solar heating systems: air heating, water heating, active and passive. Residential and commercial applications are also discussed. The performance of thermic panels are compared to conventional solar systems. A computer simulation of thermic panels in a residential space-heating application resulted in predictions of the percentage of solar heat provided by the panels. The predictions are compared to similar analyses of conventional solar systems. Thermic panels did as well or better than conventional systems in the six climate types investigated. However, since their installed cost is less, they are expected to be more economic than conventional solar systems. Thermic panels improve the economics of flat-plate collectors by their modularity and simplicity. Modularity reduces installation costs and raw materials cost; simplicity reduces maintenance costs. Furthermore, the panels can be integrated into the buildings structure, saving the cost of the wall or roof elements they replace.
Missouri River Development Policy and Rural Community Development

: Federal planners, in proposing the massive main stem Missouri River water developments in Montana and North Dakota, promised economic and social benefits to the local residents. Five main stem dams, Fort Peck, Garrison, Oahe, Big Bend and Fort Randall, were evaluated for community and rural development effectiveness. Thirty-seven development factors were examined and improvements noted. Only small differences were noted between areas with water developments and the control area. Further analysis revealed that water development benefits moved downstream and to existing urban areas. The Missouri River's rural areas and small communities were not developed significantly by the water projects. Several problems associated with water development policy were illustrated by the study. Cultural differences between planners and the population impacted were ignored. Second, the allocation of social costs was not considered and related to this, serious geographic maldistribution of benefits and costs resulted. The differences between pre-development promises and development performance was dramatic. While the large dams remain as landmarks to engineering prowess, the projects need to be evaluated for their success in meeting humanistic development objectives. Major redevelopment may be warranted by such an ex-post evaluation.
Short-channel effects in sub-100 nm GaAs MESFETs

GaAs MESFETs with gate lengths ranging from 260 nm down to 30 nm have been fabricated using high resolution electron-beam lithography. The DC characteristics including transconductance, output conductance, threshold voltage, and subthreshold current of these devices have been measured. Short-channel effects manifested as a negative shift in threshold voltage and an increase in output conductance have been observed as the gate length decreased. These effects become pronounced as the device aspect ratio (gatelength/channel thickness) falls below 5. Subthreshold current increased with a decrease in gate length and is actually an exponential function of the gate bias for gate dimensions below 100 nm. Also, subthreshold current is an increasingly more sensitive function of the drain-to-source voltage as the gate-length is reduced. The observed effects are attributed to the space charge limited electron injection into the GaAs buffer layer under the channel.
The Use of the Second Law of Thermodynamics in Process Design

The importance of using the second law of thermodynamics in the design of heat exchangers, heat exchanger networks, and processes in general, is discussed. The optimal {Delta}T at a refrigerated heat exchanger is considered from a second law viewpoint. It is shown that the use of minimum total annualized cost as the single optimizing factor is unsatisfactory. Total annualized costs are based on predicted costs of fuel, equipment, and capital, which are uncertain at best. Instead of a singular or ``global optimum`` {Delta}T, there is a range of optimal {Delta}Ts over which the total annualized cost is essentially the same, but within which the distribution between cost of capital and cost of energy is significantly different. In selecting a design {Delta}T, this distribution of costs should also be considered. The possibility of only one singular, or global optimum, solution for complex processes is also considered from a philosophical viewpoint, and is again rejected. The existence and identification of design decisions which unnecessarily waste thermodynamic availability (physical exergy) are discussed and identified as ``second law errors.`` Elimination of a second law error from a design guarantees an improved design. An optimal design, which may be any one of a numerous setmore » of optimal designs, will result when all second law errors are eliminated. A design procedure to develop optimal process designs, using such thermodynamic insights, is proposed.« less
Analytical and Experimental Study of Potential Heat Recovery From Household Refrigerators

Opportunities for waste recovery exist in many types of industrial devices as summarized by Kreith and West [1]. However, no experimental data regarding the potential of heat recovery from household refrigerators have been published in open literature. The decision to implement a heat recovery option depends mostly on convenience and cost. In some cases, however, the decision is difficult because there is a lack of reliable information of the payback for a potential application. This article provides useful information for the design and payback of a waste heat recovery system on a household refrigerator. This paper presents experimental and analytical results of energy recovery potential from the heat rejected by the condenser coils of a household refrigerator. Using a small heat exchanger affixed to the condenser coils, the heat thus recovered can preheat domestic tap water. The analytical study considered three designs: A heat exchanger with the refrigerant condensing on the outside of water pipes, refrigerant on the inside of a counter-flow heat exchanger, and the refrigerant condensing inside a serpentine coil enclosed by a container filled with household tap water. Considering economic feasibility and manufacturing ease, the serpentine coil design was chosen. Experimental data confirmed the heat recovery possibility from the condenser coils. The serpentine coil design can achieve a payback time of 2 to 10 years dependent on whether the domestic hot water uses electric or gas heating.Copyright © 2004 by ASME
Assessment of four rapid urease test systems for detection of Helicobacter pylori in gastric biopsy specimens.

Abstract An in vitro experiment and an in vivo clinical trial were both performed in order to assess the efficacy of four biopsy urease test systems, including one commercial kit, Temmler CUT test (Temmler Pharma, Marburg, Germany), for the rapid detection of Helicobacter pylori . We first evaluated four rapid urease test systems by inoculating bacterial suspensions of different concentrations into urea-containing media and observing the color change at room temperature. We found that the CUT test was superior in vitro to the other three urease test systems. As was expected, the lower the concentration of the inoculum, the slower was the color change and the fewer were the positive results noted. The minimal concentration of H. pylori for a positive urease test at 24 h was 1,000–10,000 colony-forming units/ml in 1 drop of bacterial suspension inoculated. We then evaluated four biopsy urease test systems for the rapid diagnosis of H. pylori infection in antral and fundal mucosa biopsy specimens of 37 patients undergoing upper gastrointestinal endoscopy. All four test systems were 100% specific when compared with culture. In 69 culture-positive biopsy specimens, the CUT test was not only more sensitive (72%) than the other three systems (42%, 51%, and 45%, respectively), but also gave the fastest reaction by detecting more culture-positive biopsy specimens after 3 h of incubation at room temperature. The differences were statistically significant.
Antimicrobial Stewardship in the Emergency Department

The practice of antimicrobial stewardship can be defined as optimizing clinical outcomes while minimizing the consequences of antimicrobial therapy such as resistance and superinfection. Antimicrobial stewardship can be difficult to transition to the emergency department (ED) since the traditional activities include the evaluation of broad-spectrum antimicrobial regimens at 72 and 96 hours and intravenous to oral medication conversion. The emergency medicine clinical pharmacist (EPh) has the knowledge and clinical assessment skills to manage an antimicrobial stewardship program focused on culture follow-up for patients discharged from the ED. This paper summarizes the experiences of developing an EPh-managed antimicrobial stewardship and culture follow-up program in the ED from 2 separate institutions. Specifically, the focus is on the steps for establishing an EPh-managed antimicrobial stewardship program, a description of the culture follow-up process, managing the culture data and cultures that require emergent notification and review, medical/legal concerns, and barriers to implementation. Outcomes data available from institutions with similar ED based antimicrobial stewardship programs are also discussed.
Effects of Mesh Density and Flow Conditioning in Simulating 7-Pin Wire Wrapped Fuel Pins

In response to the goals outlined by the U.S. Department of Energy’s Global Nuclear Energy Partnership program, Argonne National Laboratory has initiated an effort to create an integrated multi-physics multi-resolution thermal hydraulic simulation tool package for the evaluation of nuclear power plant design and safety. As part of this effort, the applicability of a variety of thermal hydraulic analysis methods for the prediction of heat transfer and fluid dynamics in the wire-wrapped fuel-rod bundles found in a fast reactor core is being evaluated. The work described herein provides an initial assessment of the capabilities of the general purpose commercial computational fluid dynamics code Star-CD for the prediction of fluid dynamic characteristics in a wire wrapped fast reactor fuel assembly. A 7-pin wire wrapped fuel rod assembly based on the dimensions of fuel elements in the concept Advanced Burner Test Reactor [1] was simulated for different mesh densities and domain configurations. A model considering a single axial span of the wire wrapped fuel assembly was initially used to assess mesh resolution effects. The influence of the inflow/outflow boundary conditions on the predicted flow fields in the single-span model were then investigated through comparisons with the central span region of models which included 3 and 5 spans. The change in grid refinement had minimal impact on the inter-channel exchange within the assembly resulting in roughly a 5 percent maximum difference. The central span of the 3-span and 5-span cases exhibits much higher velocities than the single span case,, with the largest deviation (15 to 20 percent) occurring furthest away from the wire spacer grids in the higher velocity regions. However, the differences between predicted flow fields in the 3-span and 5-span models are minimal.Copyright © 2008 by ASME and UChicago Argonne, LLC, Operator of Argonne National Laboratory
On Fractal Cracks in Micropolar Elastic Solids

this paper we review the fracture mechanics of smooth cracks in micropolar (Cosserat) elastic solids. Griffith's fracture theory is generalized for cracks in micropolar solids and shown to have two possible forms. The effect of fractality of fracture surfaces on the powers of stress and couple-stress singularity is studied. We obtain the orders of stress and couple-stress singularities at the tip of a fractal crack in a micropolar solid using dimensional analysis and an asymptotic method that we call "method of crack-effect zone." It is shown that orders of stress and couple-stress singularities are equal to the order of stress singularity at the tip of the same fractal crack in a classical solid. ©2002 ASME
Two-Mirror Systems with Spherical Reflecting Surfaces

An analysis is made of two-mirror systems consisting of spherical reflecting surfaces. Solutions are found for those systems having zero third-order spherical aberration. It is shown that no practical solution exists for the configuration resembling the Cassegrainian telescope; there are three one-parameter families of solutions. These are given by c1=(q−1)/2t0t1=(t0−f)/qc2=q/2ft0=(27f/32)sec2θq=−3[1+4cos23(θ+πr)]−1,where c1 and c2 are the two curvatures; t1 the axial separation of the two reflecting surfaces; t0 the distance from a focus to the corresponding surface; and f the focal length. The free parameter is θ and r = 0, 1, −1.
Review of Global Health: Diseases, Programs, Systems and Policies

Global Health: Diseases, Programs, Systems and Policies is an excellent textbook specifically designed for the graduate training programs in global public health.
Treatment experience in patients with anti-myelin-associated glycoprotein neuropathy.

We report our experience with 24 consecutively treated patients (15 men and 9 women, median age 64 years) with anti-myelin-associated glycoprotein (anti-MAG) neuropathy. The rates of response to plasma exchange (40%), immune globulin (16%), and cyclophosphamide-based therapy (36%) were similar. Five (24%) responded to the first treatment modality, 32% to a second, alternative modality, and 31% to a third. Only 4 of 12 responders had sustained improvement; the others relapsed after a median of 7 months. In those 4 patients, the median immunoglobulin M (IgM) level dropped by 25% compared to an increase of 24% in the nonresponders (P = 0.04). Thus, most patients with anti-MAG neuropathy failed to have sustained improvement after treatment, and none of the therapies emerged as superior. Disability improved transiently after therapy in approximately 50% of cases. A 25% reduction of the IgM level predicted sustained improvement, but was difficult to achieve. There were no clinical or electrodiagnostic features associated with a treatment response, nor did a reduction of the anti-MAG antibody titer correlate with clinical improvement.
The flipped classroom: a modality for mixed asynchronous and synchronous learning in a residency program.

Introduction: A “flipped classroom” educational model exchanges the traditional format of a classroom lecture and homework problem set. We piloted two flipped classroom sessions in our emergency medicine (EM) residency didactic schedule. We aimed to learn about resident and faculty impressions of the sessions, in order to develop them as a regular component of our residency curriculum. Methods: We evaluated residents’ impression of the asynchronous video component and synchronous classroom component using four Likert items. We used open-ended questions to inquire about resident and faculty impressions of the advantages and disadvantages of the format. Results: For the Likert items evaluating the video lectures, 33/35 residents (94%, 95% CI 80%-99%) responded that the video lecture added to their knowledge about the topic, and 33/35 residents felt that watching the video was a valuable use of their time. For items evaluating the flipped classroom format, 36/38 residents (95%, 95% CI 82%-99%) preferred the format to a traditional lecture on the topic, and 38/38 residents (100%, 95% CI 89%-100%) felt that the small group session was effective in helping them learn about the topic. Most residents preferred to see the format monthly in our curriculum and chose an ideal group size of 5.5 (first session) and 7 (second session). Residents cited the interactivity of the sessions and access to experts as advantages of the format. Faculty felt the ability to assess residents’ understanding of concepts and provide feedback were advantages. Conclusion: Our flipped classroom model was positively received by EM residents. Residents preferred a small group size and favored frequent use of the format in our curriculum. The flipped classroom represents one modality that programs may use to incorporate a mixture of asynchronous and interactive synchronous learning and provide additional opportunities to evaluate residents. [West J Emerg Med. 2014;15(7):-0.]
Tillage Management for Cotton in Southeastern Coastal Soils during Dry Years

With rising energy costs, expensive deep tillage needs to be reevaluated. In 2002 and 2003, tillage treatments were evaluated for effectiveness in increasing cotton yield when noninversion deep tillage was either performed annually or not. Tillage treatments included a nontilled control, a straight-legged subsoil shank with bedding, and strip tillage with each of the following: a straight-legged subsoil shank, a Paratill, and a Terra-Max. In 2003, treatments were split with half the plots tilled and half not. No-tillage treatment significantly reduced penetration resistances better than others. Tillage decreased penetration resistance and improved yield but differences were significant only half the time. Treatments not tilled in the second year did not have significantly reduced penetration resistance because of a lack of recompaction during a dry first growing season. Tilling the second year improved yield marginally. Producers need to decide whether to till after a dry year on a case-by-case basis.
Fostering the social and emotional development of gifted children through guided viewing of film

Teachers of gifted elementary school students seek strategies appropriate for fostering healthy social and emotional development in children. The authors propose guided viewing of film as a strategy through which teachers and counselors may assist young gifted students in gaining helpful insights to deal with problems they face. This article presents a theoretical foundation for this approach, a variety of strategies for implementation, and a collection of films appropriate for use with gifted students.
Pulmonary function tests and blood gases in worsening myasthenia gravis

The aim of this study was to determine whether pulmonary function tests have a role in predicting the need for ventilation support in myasthenia gravis. Medical records were reviewed for 42 patients with severe myasthenia gravis who required 55 admissions to the intensive care unit. Patients with a vital capacity of more than 20 ml/kg, a maximal expiratory pressure more than 40 cm H2O, or a maximal inspiratory pressure more negative than −40 cm H2O are unlikely to require mechanical ventilation. A decline of 30% or more in maximal inspiratory pressure predicted a group at higher risk of requiring mechanical or noninvasive ventilation. Hypercapnia was frequent and was more common in patients who required mechanical ventilation. Worsening of these pulmonary function and blood gas values in patients with myasthenia gravis may guide decisions about intubation and ventilatory support. Muscle Nerve, 2005
Bioelectronic Devices Controlled by Biocomputing Systems

This paper outlines recent advances in the integration of enzyme-based biocomputing systems operating as Boolean logic gates and their networks with various bioelectronic devices. “Smart” switchable electrodes for biosensors and biofuel cells with built-in biomolecular logic were designed. Interfacing between the biocomputing systems and switchable electrodes resulted in bioelectronic devices controlled by complex patterns of variable biomolecular signals. Various biomedical applications of the novel logically-controlled bioelectronic devices are feasible.
Survival according to the site of bronchial microscopic residual disease after lung resection for non-small cell lung cancer

Objective We performed a retrospective study evaluating the effect on survival of different sites of microscopic residual disease at the bronchial resection margin after surgical intervention for non–small cell lung cancer. Methods Survival of patients with different sites of residual disease was compared with survival of patients with curative resections, taking the pathologic TNM stage of the tumor into consideration. Results There was a trend for patients with stage I and II non–small cell lung cancer with residual disease limited to the epithelium and with peribronchial invasion to behave like patients with complete resections (61% and 41% five-year survival for stage I and II disease, respectively). This contrasts with patients with submucosal invasion and lymphatic infiltration, among whom there were no survivors at 5 years. There was no difference in survival between curative resections and residual disease of any type when the tumor was stage III or IV. Conclusions In patients with stage I and II disease, when residual disease consists of submucosal invasion or lymphatic infiltration, specific and aggressive treatments to clear residual margins might be contemplated because of their possible adverse effect on survival. This contrasts with patients with stage III and IV disease, in whom survival is more related to the stage of the primary tumor than to residual disease.
Sickle cell mouse models are hot

The development of ingenious mouse models of sickle cell disease by variable loss or removal of mouse globin genes and transgenic introduction of human α and βSand/or βS-Antilles globin genes has profoundly improved the opportunities to understand the complex pathophysiology of the sickling
Asymmetric network connectivity using weighted harmonic averages

We propose a non-metric measure of the "closeness" felt between two nodes in an undirected, weighted graph using a simple weighted harmonic average of connectivity, that is a real-valued Generalized Erdos Number (GEN). While our measure is developed with a collaborative network in mind, the approach can be of use in a variety of artificial and real-world networks. We are able to distinguish between network topologies that standard distance metrics view as identical, and use our measure to study some simple analytically tractable networks. We show how this might be used to look at asymmetry in authorship networks such as those that inspired the integer Erdos numbers in mathematical coauthorships. We also show the utility of our approach to devise a ratings scheme that we apply to the data from the NetFlix prize, and find a significant improvement using our method over a baseline.
Actin overexpression parallels severity of pancreatic injury.

Abstract Among the three major cytofilament proteins, keratin (K8/K18/K19) expression increases nearly threefold upon pancreas or liver injury, while actin and tubulin expressions are considered relatively stable. K8/K18 serves essential hepatocyte cytoprotective functions yet appears dispensable in K8-null mouse pancreata, which led us to hypothesize that actin or tubulin expressions may increase after pancreatic injury. Balb/c and FVB/n mice manifested different susceptibility to injury in two pancreatitis models, with significant induction of actin protein (threefold) and RNA after moderate or severe but not mild injury. Alterations in tubulin expression were less prominent. Basally, K8-null and wild-type pancreata expressed similar actin and tubulin levels, while the injury-induced actin protein but not RNA was more pronounced in K8-null mice. K7/K18/K19/K20 were also induced in K8-null mice after injury. Ex vivo, caerulein-triggered pancreatitis caused protein degradation (actin ≅ tubulin > keratins) and mRNA up-regulation that was blocked by actinomycin-D (act-D) (actin ≅ tubulin ≅ keratin) or by NF-κB inhibition (keratins > actin ≅ tubulin). Hence, actin is not as static as previously held and is overexpressed after moderate to severe pancreatic injury while keratins are induced after minimal injury. Keratin and actin induction may serve protective roles in pancreatic injury.
A Pragmatic Methodology for Social Economics: A Preliminary Proposal

A widely accepted belief holds that social economics is logically inconsistent with the pragmatic philosophy. This view has been very clearly and forcibly expressed by Mark A. Lutz at the Third World Congress for Social Economics. Lutz has summarised his conclusions in the following quotation:
Endogenic modification of impact craters on Mercury

The presence of internally modified impact craters on Mercury's surface may be used to evaluate the possibility of Mercurian volcanism. Such craters are similar to the floor-fractured and mare-filled craters observed on the moon. Mariner-10 images show that most such craters occur, as on the moon, near plains-filled basins. Color-ratio images have indicated that some Mercurian craters manifest red plains materials on their floors. These features may be associated with lava analogous to mare basalts in some lunar craters, or with compositionally distinct subsurface material preserved within the impact crater. Several basins manifest photometric contrasts between basin exteriors and basin-filling plains. Dark haloes are observed around some impact craters superimposed on the interior plains. This suggests the excavation of compositionally distinct material. Some possible endogenic features are discerned, despite the poor surface resolution, such as irregular rimless depressions. It is felt that volcanism may have occurred on Mercury, and that in some areas it may be similar to that of the lunar Mare Australe region.