cssi/SciSciGPT-SciSciNet huggingface dataset:
Factors associated with unplanned reoperation in perilunate dislocations and fracture dislocations.

Background Perilunate injuries are complex and uncommon injuries that are typically the result of a high-energy injury and are nearly always treated operatively. Little is known about factors associated with unplanned reoperations after surgery for perilunate injuries. Purpose To assess the rate and types of unplanned reoperation after operative treatment of a perilunate dislocation. Patients and Methods We reviewed 115 patients of all ages with unplanned reoperations after operative treatment of perilunate injuries at five hospitals. Planned removal of implants were not considered as unplanned reoperations. Results Sixteen patients had an unplanned reoperation, including four for compartment syndrome (three hand, one forearm); three for deep infection; three for malalignment or an errant screw; two for early salvage procedures; and four for other reasons. We considered seven unplanned reoperations necessary (forearm compartment syndrome, infection, loss of alignment, errant screw) and nine debatable or unnecessary (hand compartment syndrome, early salvage procedures, suspected malunion, etc.). Patients who had an unplanned reoperation were younger (median age 24 versus 34 years; p = 0.0034); had earlier surgery (median days to surgery 0 versus 3; p = 0.0068); and were more likely injured in a motor vehicle collision (50% versus 17%; p = 0.0070). Accounting for interaction among the variables using multivariable analysis, the factors independently associated with unplanned reoperation were young age (odds ratio 0.92) and motor vehicle collision accidents (odds ratio 4.1). Conclusion We conclude that higher-energy injuries may be at greater risk for unplanned reoperation, but more than half of the unplanned reoperations were for debatable indications. Level III Retrospective Cohort Review
Imagined Interactions as a Deterrent to Students' Antisocial Email Requests:

This study examined the role of imagined interactions (IIs) in student email to their teachers due to the cultural popularity of social media usage. One hundred seventeen students were placed in an imagined interaction condition or a distracter task condition. Using their laptops, students were given a request scenario on which to construct and send an email to an instructor. Four hypotheses were tested. Results indicated that students who had an II prior to sending their email were more likely to use prosocial strategies to make their requests. Students in the II condition were also less likely to use the most direct, antisocial compliance gaining strategies. Additional findings are reported and discussed.
Bruce Schneier: Building Cryptographic Systems

Security expert Bruce Schneier discusses security from the perspectives of both the National Security Agency and the National Institute of Standards and Technology. The first Web extra at https://youtu.be/opT6pIfyGUs is a video interview with Bruce Schneier, who talks about security from the perspectives of both the National Security Agency and the National Institute of Standards and Technology. The second Web extra at https://youtu.be/DmmpbkPw5dk is an audio recording in which author Charles Severance discusses his interview with security guru Bruce Schneier about security from the perspectives of both the National Security Agency and the National Institute of Standards and Technology.
Evaluation of Enterococcus concentrations at beaches in Door County, WI (Lake Michigan, USA) by qPCR and defined substrate culture analysis

Abstract The US EPA (Environmental Protection Agency) has approved the use of a quantitative polymerase chain reaction (qPCR) method for surface water regulatory decisions. This method would allow for results in as little as 4 h, rather than the 24 + hours for culture-based tests. The US EPA qPCR Method 1611 is enterococci-based, whereas the Great Lakes states adopted Escherichia coli as the indicator organism of choice. The change in indicator organism, method, and the heterogeneous nature of Great Lake beaches present challenges to implementation of rapid methods. The objective of this study was to determine the feasibility of using qPCR for beach water monitoring and management in rural, northern Lake Michigan communities. Concentrations of fecal indicator bacteria (FIB) were different in each method and varied greatly by beach. When concentrations of enterococci by TaqMan Enterococcus qPCR (EntTaq) were compared with E. coli using Colilert, positive correlations were detected only at Baileys Harbor, Fish Creek and Sunset Park Beaches (r 2 = 0.26, r 2 = 0.22 and r 2 = 0.36, respectively). When enterococci concentrations determined by EntTaq were used for management decisions, the EntTaq method would have resulted in 47 false positive and 27 false negative results when compared to culture-based decisions. When management decisions based on E. coli concentrations were obtained from Colilert, EntTaq would have resulted in 35 false positive and 49 false negative results. This study suggests that, although minimally trained individuals can obtain appropriate results using qPCR methods, each beach community should carefully evaluate the impact of adopting rapid methods for beach management decisions.
Effect of rice wine on serum total cholesterol content in hyperlipidemic rats

In this paper,the effect of rice wine on lowering serum total cholesterol(TC) was studied by animal test.The male SD rats were fed with high fat feedstuff to obtain model animals with high blood fat.Then the model rats were fed with rice wine of different doses.The result showed that rice wine condensate had the effect of lowering serum total cholesterol.
Effects of feed or water restriction, antibiotic injection and receiving diet management on commingled feeder pig performance.

An experiment was conducted to determine the effects of 1) long-acting oxytetracycline injection at market arrival, 2) feed or water access at the auction market and 3) receiving diet management on commingled feeder pig performance. A total of 288 commingled feeder pigs transported over 1,000 km after market management treatments were used in two trials. Pigs given access to feed and water (FW) at the market weighed more (P less than .001) following marketing and transport than pigs given water only (W). Pigs given neither feed nor water (N) were intermediate in arrival weight (19.7, 18.7 and 18.9 kg). There was no effect (P greater than .1) of feed and water offering at the market on final weight (96.6, 95.9 and 96.6 kg), overall average daily gain (.70, .69 and .70 kg/d), overall gain/feed (.31, .31, .32) or percentage death loss (1.0, 2.1 and 4.2%). Injection of long-acting oxytetracycline upon arrival at auction market had no effect (P greater than .1) on pig weight following marketing and transport (19.0 vs 19.2 kg), final weight (96.1 vs 97.0 kg), percentage death loss (3.4 vs 1.4%) or percentage of pigs treated (3.4 vs 4.9%). Compared to providing ad libitum access to feed, restricting feed intake by floor feeding for the first 7 d post-arrival reduced (P less than .01) rate of gain for the first 9 d (-.04 vs. .08 kg/d), but overall there was no effect (P greater than .1) on daily gain (.70 vs .69 kg/d) or gain/feed (.31 vs .31).
Palamas and Aquinas

The eastern tradition as we have presented it so far is rich but polyphonic. One finds terms as fundamental as energeia and “the things around God” being used differently by different authors, and concepts such as ceaseless prayer and the uncreated light achieving great importance without any attempt to incorporate them into a dogmatic synthesis. No doubt part of the reason was the strong sense of unanimity within the tradition as a whole. There was never any sudden loss of texts, or division into schools, or rise of a scholastic method – all factors that, had they occurred, would have encouraged authors to look for shortcomings within the tradition and to emphasize their own originality. The Byzantines took for granted that what had been said by the Fathers was correct and complete, and they saw their own task as that of applying this inherited wisdom to the issues at hand. Consequently, even a step of great originality was rarely heralded as such. Behind this conservatism there lay also a deeper cause, namely the apophaticism at the root of the entire tradition. What is the point of spinning out words about God when He can be known only through practice? On such a view theology, however complex it may become, is ultimately simply the enterprise of preserving “the faith once delivered to the saints.”
Diagnostic Inaccuracies in Children with “First Seizure”

A prospective cohort study of 127 children aged 1 month through 17 years seen in the First Seizure clinic at the Alberta Children's Hospital between Jan 1, 2004 and August 30, 2005 determined the range of diagnoses and the prevalence of previous unrecognized seizures.
Management of Design Information Flows

Design of human artifacts has evolved from a craftsman process in which designing was part of fabrication to a separate process involving hundreds of people, each with specialized knowledge. Complex information flows have evolved that are now significantly affecting the quality of design. A model for representing and managing design information flows is developed and some opportunities for new research outlined.
Effective Teaching and Jesus: Do Jesus’ Instructional Methods Align with Effective Teaching Research?

Too many students are being left behind in the learning process and ineffective teaching is often the blame. Effective teaching research provides a practical approach to helping teachers improve how “they deliver their knowledge skills while interacting with students in the classroom” (Stronge in Evaluating what good teachers do: eight research-based standards for assessing teacher excellence. Eye on Education, Larchmont, p. 43, 2010). Many educators claim that Jesus Christ was the “Master Teacher,” but would Christ be considered an effective teacher by today’s teaching standards? The purpose of this study is to: (1) Identify how Jesus implemented effective instructional delivery strategies in His teaching, and (2) Analyze Christ’s teaching methods for further insights to help teachers in the K-12 school. The study used the framework of Stronge’s Instructional Delivery Assessment tool (Stronge in Evaluating what good teachers do: eight research-based standards for assessing teacher excellence. Eye on Education, Larchmont, 2010), along with related components from assessment tools by Danielson (The framework for teaching: evaluation rubric (ed). Charlotte Danielson, 2014) and Marzano (The Marzano teacher evaluation model. The Marzano Research Laboratory, Englewood, 2013), to study the instructional delivery strategies of Jesus in the Gospel of Matthew. Specifically, the study examined Jesus’ use of differentiated instruction, cognitive challenge, student engagement , effective questioning , and relevance or relatedness. The results were that Jesus consistently applied the effective instructional delivery strategies of differentiated instruction, cognitive challenge, student engagement, effective questioning, and relevance in His teaching. Christ’s use of instructional delivery strategies also offers practical tools for Christian teachers in K-12 schools.
Prospects for an Assay Technique Based on Volatile Enzyme Products

After considering a simple mathematical model (1) similar to that used for the thermal enzyme probe (2), it was decided to explore (3) an assay technique in which immobilized enzyme catalyzed reactions yielding volatile products are interfaced to a relatively inexpensive mass spectrometer, as shown in Fig. 1.
A Subthreshold Voltage Reference With Scalable Output Voltage for Low-Power IoT Systems

This paper presents a subthreshold voltage reference in which the output voltage is scalable depending on the number of stacked PMOS transistors. A key advantage is that its output voltage can be higher than that obtained with conventional low-power subthreshold voltage references. The proposed reference uses native NMOS transistors as a current source and develops a reference voltage by stacking one or more PMOS transistors. The temperature coefficient of the reference voltage is compensated by setting the size ratio of the native NMOS and stacked pMOS transistors to cancel temperature dependence of transistor threshold voltage and thermal voltage. Also, the transistor size is determined considering the trade-off between diode current between n-well and p-sub and process variation. Prototype chips are fabricated in a 0.18- $\mu \text{m}$ CMOS process. Measurement results from three wafers show $3\sigma $ inaccuracy of ±1.0% from 0 °C to 100 °C after a single room-temperature trim. The proposed voltage reference achieves a line sensitivity of 0.31%/V and a power supply rejection of −41 dB while consuming 35 pW from 1.4 V at room temperature.
Neurotoxic Doses of Chronic Methamphetamine Trigger Retrotransposition of the Identifier Element in Rat Dorsal Dentate Gyrus

Short interspersed elements (SINEs) are typically silenced by DNA hypermethylation in somatic cells, but can retrotranspose in proliferating cells during adult neurogenesis. Hypomethylation caused by disease pathology or genotoxic stress leads to genomic instability of SINEs. The goal of the present investigation was to determine whether neurotoxic doses of binge or chronic methamphetamine (METH) trigger retrotransposition of the identifier (ID) element, a member of the rat SINE family, in the dentate gyrus genomic DNA. Adult male Sprague‐Dawley rats were treated with saline or high doses of binge or chronic METH and sacrificed at three different time points thereafter. DNA methylation analysis, immunohistochemistry and next‐generation sequencing (NGS) were performed on the dorsal dentate gyrus samples. Binge METH triggered hypomethylation, while chronic METH triggered hypermethylation of the CpG‐2 site. Both METH regimens were associated with increased intensities in poly(A)‐binding protein 1 (PABP1, a SINE regulatory protein)‐like immunohistochemical staining in the dentate gyrus. The amplification of several ID element sequences was significantly higher in the chronic METH group than in the control group a week after METH, and they mapped to genes coding for proteins regulating cell growth and proliferation, transcription, protein function as well as for a variety of transporters. The results suggest that chronic METH induces ID element retrotransposition in the dorsal dentate gyrus and may affect hippocampal neurogenesis.
Effect of sodium nitroprusside on sperm motility, viability, and lipid peroxidation

Objective To analyze the effect of sodium nitroprusside, a nitric oxide releaser, on sperm motion and lipid peroxidation-induced membrane damage in cryopreserved human sperm. Design Post-thaw, cryopreserved, human sperm samples were washed and divided into three aliquots. Each aliquot was incubated with either 0, 50, or 100 nM sodium nitroprusside. Interventions Samples were analyzed for lipid peroxidation (measured by malonaldehyde-thiobarbituric acid reactivity) at 3 hours post-thaw. Main Outcome Measures Percent viability and motion parameters were assessed at 0, 10, and 30 minutes and 2, 3, 5, and 6 hours post-thaw. Results All results represent a mean ± SEM, n=10. Lipid peroxidation in samples incubated with 50 nM sodium nitroprusside (15.1 ± 2.1 nM malonaldehyde/10 8 sperm) or 100 nM sodium nitroprusside (13.2 ± 2.1 nM malonaldehyde/10 8 sperm) was significantly lower than in controls (22.7 ± 3.1 nM malonaldehyde/10 8 sperm). Percent viability was significantly reduced from 0 minutes (60.6% ± 3.5%) to 6 hours post-thaw in controls (38.0% ± 5.1%) but not in 50 nM (46.8% ± 10.4%) or 100 nM (48.8% ± 6.5%) sodium nitroprusside-treated samples. Compared with controls (18.3% ± 3.4%), maintenance of percent motility at 3 hours post-thaw was significantly improved in 50 nM (24.5% ± 2.9%) and in 100 nM (26.3% ± 3.2%) sodium nitroprusside-treated samples. Straight line velocity maintenance was significantly improved in 50 nM (37.3 ± 1.3) and in 100 nM (37.0 ± 1) sodium nitroprusside-treated samples as compared with controls (30.5 ± 1.7). Significant improvements in curvilinear velocity maintenance compared with controls (56.3 ± 2.9) also were observed in 50 nM (65.9 ± 2.1) and 100 nM (72.1 ± 4.1) sodium nitroprusside-treated samples. Significant differences in the motion parameters of sodium nitroprusside-treated samples were maintained at 5 and 6 hours post-thaw in comparison to controls. Conclusion These results suggest that sodium nitroprusside is beneficial to the maintenance of post-thaw sperm motion and viability for up to 6 hours and that reduction of lipid peroxidative damage to sperm membranes may be the mechanism for these benefits.
Housing Interventions and the Chronic and Acute Risks of Family Homelessness: Experimental Evidence for Education

This study considers risk associated with family homelessness for school functioning and experimental evidence on the effects of different housing interventions over time. Students in homeless families (N = 172; Mage = 7.31; SD = 4.15) were randomized to housing interventions that focus on acute risks (community-based rapid rehousing), chronic risks (permanent subsidy), or usual care (UC). A matched group of low-income, housed students served as an additional reference for effects on attendance, school mobility, and reading and math achievement across 4 years. Findings partially support the chronic-risk hypothesis that family homelessness interferes with achievement through its relation to deep poverty. Children randomly assigned to UC perform as well or better than children assigned to housing interventions in this municipality. [ABSTRACT FROM AUTHOR]
Central adrenergic regulation of cerebral microvascular permeability and blood flow: pharmacologic evidence.

Evidence from anatomic and physiologic studies has led to the development of a central adrenergic neurohumoral hypothesis. This hypothesis proposes that the central adrenergic system is part of an intra-axial autonomic system distinct from the peripheral sympathetic system, but having analogous functions. One specific function predicted by this concept is modulation of cerebral microvascular permeability and flow.
Gradient-Related Constrained Minimization Algorithms in Function Spaces: Convergence Properties and Computational Implications

Good finite-dimensional approximations to projected gradient and conditional gradient iterates in feasible sets of L p functions u(-): [0,1] →U are relatively easy to compute when U is a simple closed convex set in Rm (e.g., an orthant, box, simplex, ball, etc.). Much is also known about the convergence behavior of the underlying infinite-dimensional iterative processes in these circumstances. Several novel features of this behavior are examined here, and the associated computational implications are explored with analytical tools and numerical experiments. The conclusions reached are immediately applicable to constrained input continuous-time optimal control problems.
In welchem ich darüber schreibe, woraus sich mein innerer Konflikt zwischen Religion und Vernunft speist, warum ich schon immer Wissenschaftler werden wollte, weshalb ich eine Anstecknadel von Professor Bienlein trage und wie ich in späten Jahren noch zu einem zweiten Mentor kam

Meine Kindheit war glucklich, besessen von Wissen, Struktur und Ordnung. Meine beiden Bruder und ich wurden von unseren Eltern in bester liberal-katholischer Tradition erzogen, wobei die Naturwissenschaften – auch die Evolution durch naturliche Selektion – im Grosen und Ganzen als Erklarung fur die materielle Welt akzeptiert wurden. Ich war Ministrant, sprach lateinische Gebete und lauschte den gregorianischen Gesangen, Messen, Passionen und Requiems von Lasso, Bach, Vivaldi, Haydn, Mozart, Brahms und Bruckner. In den Sommerferien besichtigte unsere Familie unzahlige Museen, Burgen sowie Barock- und Rokokokirchen. Meine Eltern und mein alterer Bruder betrachteten ehrfurchtig Deckenmalereien, Buntglasfenster, Statuen und Fresken, die religiose Szenen darstellten, wahrend meine Mutter alle Einzelheiten uber das jeweilige Objekt zu unserer Erbauung laut vorlas. Ich fand diese kunsthistorische Zwangsernahrung zwar grasslich langweilig und kann bis heute nur mit einem gewissen Schaudern den dreibandigen Kunstfuhrer meiner Mutter im Bucherregal betrachten, aber ich entwickelte eine Liebe fur den magischen Singsang jahrhundertealter lateinischer Gebete und der sakral-schlichten Musik jener Komponisten.
Gender- and School-Level Correlates of Growth in Health-Related Fitness Knowledge among US High-School Students.

Objective:Health-related fitness knowledge holds the potential for physical activity and behavioural changes. The purpose of this retrospective longitudinal study with retrospective data was (a) to...
Counseling Patients for Renal Replacement Therapy Based on Outcomes

A 52-year-old woman with autosomal dominant polycystic kidney disease (ADPKD) presents for nephrology follow-up. Her most recent serum creatinine is 2.9 mg/dl and estimated glomerular filtration rate (eGFR) is 28 ml/min/1.73m2. She is married, has no children, and works full-time as a health care administrator. She feels well except that she finds herself more fatigued at the end of each workday than at previous visits. She denies nausea, anorexia, edema, or pruritis. She has not required erythropoietic stimulating agents to date. One sister with ADPKD has received a transplant from a brother. One other sister, age 54, has had a normal renal ultrasound and is interested in donating a kidney to the patient. The patient wishes to discuss her future renal replacement therapy (RRT) options.
A Contactless Method of p-n Junction Leakage Testing and Comparison of Associated Data with Contact-Determined Leakage

A contactless p-n junction leakage measurement method is described, which uses specialized very-high-frequency oscillator circuitry. This circuitry utilizes the eddy current loading effect, via inductive coupling, in order to determine the leakage-dependent decay time of the photoinduced voltage across the diffused p-n junctions in a silicon wafer. The contactless measurement is made under low forward bias conditions (≤10 mV), in such a way that this measurement and the contacting reverse leakage, measured at 100 mV, will both be functions of generation-recombination processes in the junction depletion region. Detectable signals were made possible by low-noise circuitry and by the increase in junction eddy currents from induced voltages across the diffused regions. The following model was derived from basic circuit theory, which relates the contactless decay time measurement, τ, to the conventional contacting reverse leakage, Jo J 0 = CkT/qτ where J 0 = reverse leakage, A/cm 2 , C = junction capacitance, F/cm 2 , r = decay time, s, and kT/q = 26 mV at T = 300 K. Good agreement was obtained between experiment and theory. The examined range was four orders of magnitude in leakage current.
Severity of disease and quality of life in parents of children with alopecia areata, totalis, and universalis: A prospective, cross-sectional study

Background Caregiver-oriented quality of life (QoL) research in alopecia areata is limited. No study has used a parent-tailored survey to examine the relationship between QoL and severity of alopecia as measured by Severity of Alopecia Tool (SALT) scores. Objectives This is a prospective study that describes QoL in parents of pediatric patients with all subtypes of alopecia areata and investigates the relationship between QoL and severity of disease, duration of disease, and age of patients. Methods Pediatric patients and their parents were invited to participate during clinic visits. Participating parents completed the Quality of Life in a Child's Chronic Disease Questionnaire (QLCCDQ) and the Family Dermatology Life Quality Index (FDLQI). A subset of children completed the Children's Dermatologic Life Quality Index (CDLQI). SALT scores at time of survey completion were recorded. Results In total, 153 patients were included. Significant mild-to-moderate negative correlations were found between SALT scores and FDLQI scores, QLCCDQ scores, and QLCCDQ emotional domain scores. Age of child correlated negatively with QLCCDQ scores but not FDLQI scores. No significant correlation was found between duration of disease and FDLQI scores, QLCCDQ scores, or QLCCDQ emotional domain scores. Limitations This study is limited by its small sample size and cross-sectional design. Conclusions Impaired parent QoL might be associated with increasing severity of disease and age of affected child but not duration of disease. Providers should tailor counseling accordingly and help parents set realistic expectations for long-term experience with the disease.
Targeted Simulation-based Leadership Training for Trauma Team Leaders

Author(s): Rosenman, Elizabeth D.; Vrablik, Marie C.; Brolliar, Sarah M.; Chipman, Anne K.; Fernandez, Rosemarie | Abstract: Introduction: Effective team leadership is linked to better teamwork, which in turn is believed to improve patientcare. Simulation-based training provides a mechanism to develop effective leadership behaviors. Traditionally, healthcare curricula have included leadership as a small component of broader teamwork training, with very few examples of leadership-focused curricula. The objective of this work is to describe a novel simulation-basedteam leadership curriculum that easily adapts to individual learners.Methods: We created a simulation-based team leadership training for trauma team leaders in graduatemedical education. Participants included second- and third-year emergency medicine and surgery residents. Training consisted of a single, four-hour session and included facilitated discussion of trauma leadership skills,a brief didactic session integrating leadership behaviors into Advanced Trauma Life Support®, and a seriesof simulations and debriefing sessions. The simulations contained adaptable components that facilitated individualized learning while delivering set curricular content. A survey evaluation was administered 7-24 months following the training to assess self-reported implementation of trained material.Results: A total of 36 residents participated in the training and 23 (64%) responded to the survey. The majority of respondents (n = 22, 96%) felt the training was a valuable component of their residency education and allrespondents reported ongoing use of at least one behavior learned during the training. The most commonly cited skills for ongoing use included the pre-arrival brief (n = 21, 91%) and prioritization (n = 21, 91%).Conclusion: We delivered a leadership-focused, simulation-based training that 1) adapted to learners’individual needs, and 2) was perceived to impact practice up to 24 months post-training. More work is needed tounderstand the impact of this training on learner knowledge and behavior, as well as patient outcomes.
Infection of Blueberry Cultivar ‘Emerald’ with a California Pierce’s Disease Strain of Xylella fastidiosa and Acquisition by Glassy-Winged Sharpshooter

Bacterial leaf scorch disease caused by Xylella fastidiosa occurs in southern highbush blueberry varieties in the southeastern United States. Susceptibility to X. fastidiosa varies by blueberry cultivar, and these interactions are often strain-specific. Xylella fastidiosa subsp. fastidiosa is the causal agent of Pierce's disease in grapevines, and it has been problematic in the San Joaquin Valley of California since the introduction of the glassy-winged sharpshooter (Homalodisca vitripennis). The glassy-winged sharpshooter is known to feed on blueberry, a crop that is expanding in the San Joaquin Valley. Currently, little is known about the potential for the spread of X. fastidiosa between grape and blueberry in this region. The ability of a Pierce's disease strain of X. fastidiosa from the San Joaquin Valley to cause disease in southern highbush blueberry and the potential for the glassy-winged sharpshooter to transmit X. fastidiosa between blueberry and grapevine were investigated. Experimental inoculations showed that the X. fastidiosa subsp. fastidiosa strain Bakersfield-1 can cause disease in blueberry cv. Emerald, and that the glassy-winged sharpshooter can acquire X. fastidiosa from artificially inoculated blueberry plants under laboratory conditions. Understanding the possibility for X. fastidiosa strains from the San Joaquin Valley to infect multiple crops grown in proximity is important for area-wide pest and disease management.
Manifestx: toward a rhetoric loaded with future

On November of 2018, NCA's Latina/Latino Communication Studies Division and La Raza Caucus (LCSD/LRC) approved a motion to accept Spanish and Portuguese-language manuscripts for conference presenta...
Impact of shelter-in-place order for COVID-19 on trauma activations: Santa Clara County, California, March 2020

Introduction The shelter-in-place order for Santa Clara County, California on 16 March was the first of its kind in the USA. It was unknown what impact this order would have on trauma activations. Methods We performed a retrospective analysis of institutional trauma registries among the two American College of Surgeons Level 1 trauma centers serving Santa Clara County, California. Trauma activation volumes at the trauma centers from January to March 2020 were compared with month-matched historical cohorts from 2018 to 2019. Results Only 81 (3%) patients were trauma activations at the trauma centers in the 15 days after the shelter-in-place order went into effect on 16 March 2020, compared with 389 activations during the same time period in 2018 and 2019 (p<0.0001). There were no other statistically significant changes to the epidemiology of trauma activations. Only one trauma activation had a positive COVID-19 test. Discussion Overall trauma activations decreased 4.8-fold after the shelter-in-place order went into effect in Santa Clara County on 16 March 2020, with no other effect on the epidemiology of persons presenting after traumatic injury. Conclusion Shelter-in-place orders may reduce strain on healthcare systems by diminishing hospital admissions from trauma, in addition to reducing virus transmission.
Improving Medical Students' OSCE Performance in Telehealth: The Effects of a Telephone Medicine Curriculum.

Purpose To report on the implementation of a telephone medicine curriculum as part of the core clerkship in pediatrics for students at Johns Hopkins University School of Medicine and evaluate the curriculum's effect on student performance on a telephone medicine case as part of a required objective structured clinical exam (OSCE). Method Using a prospective cohort design with a convenience sample of third-year medical students during the 2016-2017 and 2017-2018 academic years, the authors compared the OSCE scores of students assigned to the curriculum to both historical and concurrent control groups of students who had not received the curriculum. Additionally, the authors compared the costs of the recommended testing by students in each group using the 2018 Centers for Medicare and Medicaid Services Clinical Laboratory Fee Schedule. Results Students assigned to the telephone medicine curriculum (students in the intervention group) had a significantly higher mean overall score on the simulated OSCE telephone medicine case compared to the students in the control groups who did not receive the curriculum (the mean score for students in the intervention group was 7.38 vs 6.92 for students in the control groups, P = .02). Additionally, the intervention group had statistically significantly lower costs for their recommended testing compared to the control groups (the median value for tests ordered by students in the intervention group was $27.91 vs $51.23 for students in the control groups, P = .03). CONCLUSIONS;: Implementing a dedicated telephone medicine curriculum for medical students improves their overall performance and delivery of high-value care via telephone medicine as part of an OSCE. Medical educators should pursue ongoing research into effective methods for teaching medical students and residents how to navigate digital encounters.
Truck platooning in the U.S. national road network: A system-level modeling approach

Abstract Truck platooning enables a group of trucks to move close together, which helps reduce truck fuel use and increase effective road capacity. In this paper, a system-level equilibrium model is developed to characterize spontaneous truck platooning with coexistence of non-platooning vehicles in a network, by explicitly accounting for the interlocking relationship among platoon formation time, truck fuel saving, and increase in effective road capacity. To equilibrate the relationships, an algorithm is proposed which involves a diagonalization approach and a bush-based algorithm to solve decomposed subproblems. The condition of proportionality is imposed to obtain unique traffic flows for each class of vehicles on road links. In addition, a spatially constrained multivariate clustering technique is employed to construct origin/destination zones that are smaller than the coarse Freight Analysis Framework (FAF) zones, while maintaining reasonable computational burden for network traffic assignment. Model implementation in the U.S. shows that platooning could lead to 7.9% fuel saving among platoonable trucks in 2025 and a comparable increase in effective capacity of platoonable road links, which would account for 60% of rural interstate roads. The fuel saving and road capacity improvement translate into an annual cost reduction of $868 million for the U.S. intercity trucking sector and reduced road infrastructure investment needs worth $4.8 billion. Extensive sensitivity analysis further reveals that fuel saving of platoonable trucks increases with platoon size but decreases with inter-truck distance in a platoon. Fuel saving potential suggests that priority should be given to rural rather than urban roads in deploying platooning technologies. As expected, greater market penetration of platooning technologies means higher fuel saving and greater increase in effective road capacity.
Das Problem mit der starken Vermehrung

Auser wenn wir sie essen konnen, empfinden wir gegen massenhaft auftretende Arten in der Regel Abneigung. Wir kontrollieren mittlerweile einen so grosen Teil der Erde, dass der Erfolg anderer Arten fast immer zu unserem Nachteil ist. Sie vernichten unsere Nahrungsmittel oder die von uns gefertigten Gegenstande, z. B. unsere Hauser.
Community engagement and the method “Learning by Teaching”: A pilot project to embrace foreign language learning from the first days

espanolEl Proyecto Ninos y Ninas Bilingues y Biculturales (NNBB), consolidado gracias a la colaboracion del centro de educacion infantil en la universidad y el departamento de lenguas modernas, combino l os objetivos de aprendizaje de dos cursos de espanol avanzado con los beneficios de aprender una segunda lengua a temprana edad. Los estudiantes universitarios desarrollaron un programa de tres semanas de duracion centrado en la ensenanza de vocabulario basico, geografia, y aspectos culturales de paises de habla hispana para ninos angloparlantes y monolingues. El objetivo de este estudio es comprender como el programa en la comunidad afecto a) las percepciones de los estudiantes universitarios sobre su participacion en la comunidad; y b) las percepciones de los estudiantes universitarios sobre el aprendizaje de lenguas a una edad temprana. Los ensayos personales escritos por los estudiantes indicaron que este programa los incentivo a participar proactivamente en la comunidad y les ayudo a experimentar de primera mano la efectividad en la habilidad que poseen los jovenes aprendices para adquirir una segunda lengua. Los padres de los ninos en el programa indicaron en el cuestionario una disposicion sistematica y consistente para implementar un programa de segundas lenguas en el curriculo de preescolar en el centro . EnglishThe community- engaged project, Ninos y N inas Bilingues y Biculturales (NNBB) forged through a partnership between the University Child Development Center and the Department of Modern Languages and Literatures, combined the learning goals of tertiary -level Spanish courses with the benefits of learning a foreign language at an early age. College students worked cooperatively to develop a 3- week program covering basic vocabulary, geography, and cultural features from Spanish -speaking countries for monolingual Eng- lish -speaking preschoolers. The purpose of the study is to understand the impact of the community- engaged program on a) coll ege students’ perceptions on their involvement in the community and b) college students’ perceptions of foreign language learning at an early age. Students’ written reflections indicated that this program stimulated th em to proactively participate more in the community and helped them to experience how quickly children are able to learn a foreign language. Participating parents revealed in the Likert - scale surveys a willingness to implement a systematic and consistent foreign language program in the preschool curriculum.
Study of Surface Diffusion through Langevin Dynamics

We present here results from theoretical investigations of adatom diffusion based on Langevin dynamics. We derive a generalized Langevin equation from a microscopic Hamiltonian and discuss its application to the study of surface diffusion. In particular, we focus on how the diffusion constant depends on the friction parameter characterizing the non-adiabatic coupling of the adatom to the substrate excitations. We discuss such topics as the validity of the transition state theory, occurrences of long jumps and memory effects in determining the prefactor and the barrier for surface diffusion.
The Mating-Type Locus of Cryptococcus: Evolution of Gene Clusters Governing Sex Determination and Sexual Reproduction from the Phylogenomic Perspective

The Cryptococcus mating-type locus (MAT) locus has emerged as an exemplary model to elucidate general principles governing the assembly and function of gene clusters. Moreover, comparative genomic studies of the evolutionary trajectory of MAT in the pathogenic Cryptococcus species complex mirror evolutionary steps that have been hypothesized to have given rise to the more complex sex chromosomes in mammals, insects, fish, and plants. These then represent examples of convergent evolution to specialized genomic regions governing sexual reproduction throughout the eukaryotic tree of life. Although the molecular nature of the homothallic sexual cycle of Filobasidiella depauperata remains to be elucidated, possible models for the homothallic life cycle of F. depauperata are discussed. In summary, comparative genomic analysis of the structure of MAT loci from Cryptococcus-related species has important implications for the hypothesized evolutionary model. The MAT genes present in these species have implications for the gene content of the ancestral homeodomain and P/R loci in the model. The P/R locus boundaries of C. heveanensis have expanded to include not only the pheromone and pheromone receptor genes but also at least one of the pheromone response pathway genes, but not all of the C. neoformans and C. gattii MAT locus gene homologs, which illuminates the serial expansions that created evolutionary strata in the MAT locus genes of the pathogenic Cryptococcus species.
Research techniques in human performance using realistic simulation

This chapter concerns the research uses of realistic patient simulators in the evaluation of different aspects of human performance of clinical personnel. The issues of human performance in health care and patient safety may be viewed as a jigsaw puzzle for which at least three different experimental approaches can provide interlocking, and complementary pieces. No single approach can give the entire picture of human error and safety. Realistic simulation has many advantages and some disadvantages for research. I believe that high-fidelity realistic simulations of patient care situations are an important tool in studying error modalities in high criticality health care environments. These environments include anesthesia, intensive care, emergency and trauma care, labor and delivery, cardiac catheterization laboratories, and cardiac arrest teams. I first discuss how simulation fits in the jigsaw puzzle with other research techniques for investigating human performance.
On Frequency Domain Loop Shaping for Self-Tuning Control

The self-tuning frequency-domain loop shaping control problem for stable minimum phase systems is considered. The resulting control scheme corresponds to an explicit self-tuning controller, where identification and control is implemented in the frequency domain, thereby taking advantage of the properties afforded by frequency domain identification schemes. The input and output signals to the system are transformed to the frequency domain via discrete Fourier transforms; subsequently the identification part recursively estimates the system's transfer function as a finite impulse response filter. The controller corresponds to a circular convolver, implemented in the frequency domain, and shapes the open loop frequency response by providing the necessary supplement of magnitude and phase in order to match an a priori closed loop frequency response.
Antibiotic prophylaxis for intrauterine contraceptive device insertion.

BACKGROUND Concern about the risk of upper genital tract infection (pelvic inflammatory disease) often limits use of the IUD, a highly effective contraceptive. Prophylactic antibiotic administration around the time of induced abortion significantly reduces the risk of postoperative endometritis.(Sawaya, 1996) Since the risk of IUD-related infection is limited to the first few weeks to months after insertion,(Lee, 1983; Farley, 1992) contamination of the endometrial cavity at the time of insertion(Mishell, 1966) appears to be the mechanism, rather than the IUD or string itself. Thus, antibiotic administration before IUD insertion might reduce the risk of upper genital tract infection from passive introduction of bacteria at insertion. OBJECTIVES To assess the effectiveness of prophylactic antibiotic administration before IUD insertion in reducing IUD-related complications and discontinuations within three months of insertion. The primary outcome was pelvic inflammatory disease (four reports) or early removals of the device (two reports). SEARCH STRATEGY We searched both MEDLINE and EMBASE, handsearches of journals through CENTRAL, and lists of references. We also wrote to international experts in the field to identify unpublished studies. SELECTION CRITERIA We included randomized controlled trials using any antibiotic compared with a placebo. We found four such trials; two had pilot study data available. DATA COLLECTION AND ANALYSIS DATA EXTRACTION We used searches of MEDLINE, EMBASE, and handsearches of journals available through CENTRAL. We also reviewed lists of references in original research and in review articles. We wrote to experts to identify unpublished trials and made telephone calls to authors to supply missing information. Two independent reviewers abstracted data. We assessed the validity of each study using methods suggested in the Cochrane Handbook. DATA SYNTHESIS We generated 2x2 tables for the principal outcome measures. We used the Peto modified Mantel-Haenszel technique to calculate odds ratios and assessed statistical heterogeneity between studies. MAIN RESULTS The odds ratios for pelvic inflammatory disease associated with use of prophylactic doxycycline or azithromycin compared with placebo or no treatment was 0.89 (95%CI 0.53-1.51). Use of prophylaxis was associated with a small reduction in unscheduled vists to the provider (OR 0.82; 95% CI 0.70-0.98). Use of doxycycline or azithromycin had little effect on the likelihood of removal of the IUD within 90 days of insertion (OR 1.05; 95% CI 0.68-1.63). Significant heterogeneity did not exist between studies. REVIEWER'S CONCLUSIONS Use of either doxycycline 200 mg or azithromycin 500 mg by mouth before IUD insertion confers little benefit. While the reduction in unscheduled visits to the provider was marginally significant, the cost-effectiveness of routine prophylaxis remains questionable. A uniform finding in these trials was the low risk of IUD-associated infection, with or without use of antibiotic prophylaxis.
Isolation of Pteroyl-γ-oligoglutamyl Endopeptidase from Chicken Intestine with the Aid of Affinity Chromatography

Abstract An enzyme which performs the first step in the catalytic release of folic acid from pteroyl-γ-oligoglutamates was isolated from chicken intestine by the use of affinity chromatography. The enzyme-interacting ligand system consisted of synthetic γ-oligoglutamyl peptides attached covalently to Sepharose 4B by cyanogen bromide activation. The retained enzyme was eluted from the affinity column with 1 m NaCl. DEAE-cellulose chromatography and gel filtration with Sephadex G-200 were required for a final purification of 1,200-fold with a 20 % recovery of the initial enzyme. The purified enzyme appeared as a single band on disc gel electrophoresis. The estimated molecular weight determined by gel filtration was 80,000, and the isoelectric point was 4.8. The isolated enzyme was characterized as specific endopeptidase which cleaves pteroyl-γ-oligoglutamates between pteroyl glutamyl-γ-glutamate (pteroyl diglutamate) and the remaining γ-glutamyl peptide. With pteroyl-γ-heptaglutamate as substrate, the Km(app) was determined as 6.3 x 10-5 m. The Vmax was 1.8 x 10-3 µmole per min.
Effect of anisotropy and groundwater system geometry on seepage through lakebeds. 1. Analog and dimensional analysis

Abstract Distribution of seepage through lakebeds is controlled partly by geometric configuration of the lake and of the groundwater system interacting with the lake. To evaluate the effect of these factors, conductive-paper electric-analog models were used to analyze a number of lake and groundwater settings having different geometric configurations. Most settings analyzed are of lakes that do not penetrate the groundwater system. The width ratio, the ratio of half the lake width to thickness of the groundwater system, is the principal geometric characteristic used in this study. Because the distribution of groundwater seepage into a lake is not uniform across the lakebed, the concept of a streamlinecrowding factor is developed, and is used to determine seepage patterns from geometric characteristics of the lake and its contiguous groundwater system. Analysis of fourteen different width ratios of lake and groundwater systems indicates that lakes can be defined by three general groups of seepage patterns, which include flow patterns, volumes and rates: (1) lakes having width ratios less than ∼ 0.6 show relatively uniform distribution of seepage across the lakebed; (2) lakes having width ratios of ∼ 0.6 to ∼ 2.0 change in absolute and relative streamline crowding in the near-shore region; and (3) lakes having width ratios greater than ∼ 2.0 show stable flow patterns near shore; however, with increasing lake width, the relative streamline crowding increases relative to that width. For deep lakes and those in anisotropic media, the crowding effect is decreased, resulting in more uniform seepage across the lakebed.
The Method of Averaging for Euler's Equations of Rigid Body Motion

We formulate the method of averaging for perturbations of Euler's equations of rotational motion. Euler's equations are three strongly nonlinear coupled differential equations that can be viewed as a three dimensional oscillator. The method of averaging is used to determine the long-term influence of perturbation terms on the motion by averaging about the nominal rigid body motion. The treatment is applicable to a large class of motions including precession with large nutation – it is not restricted to small motions about simple spins or nearly axi-symmetric bodies. Three examples are shown that demonstrate the accuracy of the method's predictions.