cssi/SciSciGPT-SciSciNet huggingface dataset:
Provisional Crown Failures in Dental School Predoctoral Clinics

Following a preliminary study indicating that at least 10 percent of single-unit crown temporary restorations failed in patients who received treatment by predoctoral students, a comprehensive examination of provisional crown failure was initiated to identify strategies to reduce the failure rate. For all provisionalized, natural tooth, single-unit crown preparations in University of North Carolina School of Dentistry predoctoral clinics for one year (N=1008), we noted tooth type, type of crown, student level, faculty coverage experience, treatment clinic, temporary material and luting agent, and retreatment (failure) of the provisional restoration. For failures, we also noted the stage of crown preparation at failure and the time since initial placement of the temporary. We analyzed these data using simple cross-tabs and logistic regression on need for retreatment (α =0.05). The failure rate was 18.75 percent (N=189). The median time to failure was twelve days; the 25 th and 75 th percentiles were six and twenty-six days. Significant risk factors, in order of odds ratio estimates, were molar tooth, second- or third-year student, and inexperienced faculty. Most provisional failures occurred during the final preparation phase of treatment. Provisional restoration failure is more frequent than was initially suspected from preliminary studies. Strategies for institutional intervention to reduce provisional restoration failure include greater attention to evaluating provisional crowns placed by inexperienced students (sophomores and juniors) and placing more emphasis on the retentiveness of provisional restorations reused following the final impression. Review of provisional evaluation procedures is also indicated for faculty who do not routinely supervise these procedures.
Developmental exposure to PCBs and/or MeHg: effects on a differential reinforcement of low rates (DRL) operant task before and after amphetamine drug challenge.

The current study assessed the effects of developmental PCB and/or MeHg exposure on an operant task of timing and inhibitory control and determined if amphetamine (AMPH) drug challenges differentially affected performance. Long-Evans rats were exposed to corn oil (control), PCBs alone (1 or 3 mg/kg), MeHg alone (1.5 or 4.5 ppm), the low combination (1 mg/kg PCBs + 1.5 ppm MeHg), or the high combination (3 mg/kg PCBs + 4.5 ppm MeHg) throughout gestation and lactation. An environmentally relevant, formulated PCB mixture was used. Male and female offspring were trained to asymptotic performance on a differential reinforcement of low rates (DRL) operant task as adults. PCB-exposed groups had a lower ratio of reinforced to non-reinforced responses than controls. Groups exposed to MeHg alone were not impaired and the deficits observed in PCB-exposed groups were not seen when PCBs were co-administered with MeHg. AMPH was less disruptive to responding in males receiving PCBs alone, MeHg alone, and 1.0 mg/kg PCB + 1.5 ppm MeHg. Paradoxically, the disruption in responding by AMPH in males given 3.0 mg/kg PCB + 4.5 ppm MeHg did not differ from controls. Exposed females from all treatment groups did not differ from controls in their AMPH response. Overall, the findings suggest that developmental exposure to PCBs can decrease DRL performance. Co-exposure to MeHg seemed to mitigate the detrimental effects of PCBs on performance. The finding that the disruptive effects of AMPH on DRL performance were lessened in some groups of exposed males suggests that alterations in dopaminergic functioning may have a role in behavioral changes seen after perinatal PCB and MeHg exposure.
Program of All-inclusive Care for the Elderly in 2002.

This year is a pivotal time for the Program of All-inclusive Care for the Elderly (PACE) because the deadline for movement from demonstration project to permanent status is just around the corner for many sites. By late November, more than a dozen programs either will apply and be granted permanent provider designation or will cease to exist, once again altering the landscape of senior consumer options. After 3 decades of development, the PACE alternative has undeniably achieved success by both clinical and financial standards, but it does not lack some current and future challenges. HISTORY AND MODEL OVERVIEW PACE is an innovative, all-inclusive approach to caring for the frail elderly under a capitated reimbursement model. Originating in San Francisco in the early 1970s, the forerunner to today’s PACE model began in the ChineseAmerican community, wherein institutionalizing aging members in a nursing home was culturally unacceptable. On Lok (Cantonese for peaceful, happy abode) Senior Services developed a comprehensive, community-based approach to maintaining the frail elderly in their homes by applying multidisciplinary primary care within a structure that placed the adult day health center and related services (social, nutrition, recreational, medical, etc.) at its center and included home, acute, and extended care as relevant. By creatively applying the principles of health maintenance organizations (HMOs) to applicants deemed otherwise eligible for institutional care, On Lok has addressed the health care system issues affecting the elderly: fragmentation, expense, and lack of creativity in communitybased care. On Lok has maintained frail elders in their homes while enabling them to receive health care, recreation, and socialization through day centers and has managed risk through common sense preventive care. 1
When the client is pregnant: Information for counselors

This article explores the issues raised by methadone maintenance during pregnancy with a focus on intervention techniques for the drug counselor. Establishing and maintaining the appropriate dose of methadone is discussed. Prenatal care issues are reviewed and the counselor is suggested as a liaison with traditional sources of prenatal care and education. Postpartum experiences in the intensive care nursery are presented and recommendations about breast feeding offered. Specific activities are suggested for the drug program.
Mean and intermittent flow of a self-preserving plasma jet.

The gas dynamics of a highly heated, ionized turbulent argon jet have been found to be self preserving in the coordinates suggested by rudimentary similarity analysis. The measured electron density in this jet is out of equilibrium with the over-all gas, and similarity in this density does not exist. The turbulent front amplitude of this flow shows the randomness expected of free turbulent flows, and its mean position bears the same relation to the flow "half-width" as in low-speed jets. The intermittency factor and the resultant mean front position and its standard deviation measured with a temperature-sensitive probe are the same as with an electron-sensitive probe. The front wavelength appears to be related to the jet scale as wake front wavelengths are related to the wake scale.
Oocyte-Expressed Interleukin 7 Suppresses Granulosa Cell Apoptosis and Promotes Oocyte Maturation in Rats

Development of ovarian follicles is regulated by pituitary-derived gonadotropins together with local ovarian paracrine factors. Based on DNA microarray data, we performed RT-PCR and immunostaining to demonstrate the expression of interleukin 7 transcripts in oocytes of preantral, antral, and preovulatory follicles in rats. We also found the expression of interleukin 7 receptor and the coreceptor interleukin 2 receptor gamma in granulosa cells, cumulus cells, and preovulatory oocytes. In cultured rat granulosa cells obtained from early antral and preovulatory follicles, treatment with interleukin 7 stimulated the phosphorylation of AKT, glycogen synthase kinase (GSK3B), and STAT5 proteins in a time- and dose-dependent manner. Furthermore, measurement of mitochondrial reductase activity indicated that treatment with interleukin 7, similar to gonadotropins, increased the number of viable granulosa cells during a 24-h culture period. Furthermore, monitoring of the activities of apoptotic enzymes (caspase 3/7) indicated that treatment with interleukin 7 suppressed apoptosis of cultured granulosa cells from both antral and preovulatory follicles following serum withdrawal. The apoptosis-suppressing actions of interleukin 7 were blocked by an inhibitor of the phosphoinositol-3-kinase (PIK3)/AKT pathway. Furthermore, treatment of cultured preovulatory follicles with interleukin 7, like treatment with human chorionic gonadotropin, induced germinal vesicle breakdown of oocytes. The stimulatory effect of interleukin 7 was also blocked by inhibitors of the PIK3/AKT pathway. The present findings suggest that oocyte-derived interleukin 7 could act on neighboring granulosa cells as a survival factor and promote the nuclear maturation of preovulatory oocytes through activation of the PIK3/AKT pathway.
Nucleation and growth of polymorphs of barbital on chemically modified surfaces in microfluidic channels

Crystallization experiments have been carried out in microfluidic devices to screen for polymorphs by crystallization on a range of surfaces. These devices consist of PDMS (polydimethylsiloxane) patterned with microchannels and then bonded to self-assembled monolayers (SAMs) of organic molecules on gold substrates. Barbital was crystallized in microchannels over five different SAMs functionalized with polar and nonpolar organic groups. Growth of polymorphs was examined under thermodynamic conditions from solutions at room temperature and under kinetic conditions by rapid cooling. The results of these experiments and the influence of chemically modified surfaces in microchannels in controlling polymorphism are discussed.
Cationic liposome and plasmid DNA complexes formed in serum-free medium under optimum transfection condition are negatively charged.

In medium where in vitro transfection is routinely performed, DC-chol liposomes alone were nearly neutral, whereas the DC-chol liposome/DNA complexes were largely negatively charged which changed only slightly at all [liposome]/[DNA] ratios (j =327.1 to 321.8 mV). Three other commercial transfection reagents, Lipofectin0, LipofectAMINE1 2000, and SuperFect1, were also largely negatively charged when complexed with DNA. The aggregation of liposomes in medium was prevented by the addition of DNA. Incubation of the complexes in medium did not change their size, charge or lipofection activity for 30 min. These results suggest that, in medium, the liposome/DNA complexes were formed at the time of mixing with negative charges. fl 2000 Elsevier Science B.V. All rights reserved.
A complex sequence recognition model

The author proposes a biologically plausible model to learn and recognize complex sequences. He uses decreasing outputs and units which order recurring symbols. Though the model does not deal with complicated details of biological neurons, it is more biologically plausible and easier to implement on real hardware than other models. It also avoids crosstalk of memorized sequences. An arbitrary number and length of sequences can be recognized. Learning of sequences is simple and it is possible to preset weights analytically. Time periods of presenting sequences and symbols do not affect recognition. >
Nuisance parameters, mixture models, and the efficiency of partial likelihood estimators

This paper establishes lower bounds for estimation in parametric statistical models in which one wishes to estimate a real-valued parameter of interest in the presence of nuisance parameters which are accruing in number in direct proportion to the number of independent observations. The formal setting requires that the nuisance parameters be independent observations from an unknown distribution. In this setting an information measure analogous to the Fisher information is derived. It is then used to generate lower bounds for the variance of unbiased estimators and also for the asymptotic variance of consistent asymptotically normal estimators. Under certain conditions, consistent asymptotically normal estimators can be generated by maximizing factors of the complete likelihood, even though the maximum likelihood estimator is inconsistent. These estimators can be fully efficient in the sense of meeting the lower bounds despite their apparent wasteful use of the likelihood, as is demonstrated, in several important examples, by the use of a natural sufficient condition.
Non hot-spot PV module using solar cells with bypass diode function

The authors started to deliver terrestrial nonhot-spot photovoltaic modules using solar cells with the bypass diode function on the market. The bypass diode function is achieved by controlling cell reverse characteristics without increasing the cost. This function gives the bypass of current flow to the shaded cell when the module is shaded by unfavorable shields such as fallen leaves. Thus the advanced modules are able to show the more power output and the lower temperature increase than the conventional modules when a part of them is shaded.
Demographic, socio-environmental, and substance-related predictors of duration of untreated psychosis (DUP)

Objective Longer duration of untreated psychosis (DUP) is associated with poorer early-course and long-term outcomes, and is a target of early detection and intervention efforts. Given the paucity of research on childhood and adolescent stressors (e.g., maltreatment and neighborhood disorder) as potential predictors of DUP, limited research on premorbid substance use as a determinant of DUP, and inconclusive findings on the association between DUP and neurocognition, we conducted three sets of analyses to address these issues. Mode of onset of psychosis was also considered, given its established role as an illness-level correlate of DUP.
On the performance of super-orthogonal space-time codes for correlated MIMO channels

The exact expression of pairwise error probabilities (PEP) for space-time orthogonal codes is derived for spatially and temporally correlated Rayleigh fading channels in this research. We adopt a moment generating function approach in developing a unified framework to facilitate the evaluation of PEP for various types of channel correlations. Under this new framework, the complexity for evaluating PEP is greatly simplified. Moreover, the simple expression provides valuable insights into the performance of space-time codes in the presence of correlated fading channels.
Mitigation of upward and downward vertical displacement event heat loads with upper or lower massive gas injection in DIII-D

Intentionally triggered upward and downward vertical displacement events (VDEs) leading to disruptions were pre-emptively mitigated with neon massive gas injection (MGI) coming from either above or below the plasma. Global indicators of disruption mitigation effectiveness (conducted heat loads, radiated power, and vessel motion) do not show a clear improvement when mitigating with the gas jet located closer to the VDE impact area. A clear trend of improved mitigation is observed for earlier MGI timing relative to the VDE impact time. The plasma edge magnetic perturbation is seen to lock to a preferential phase during the VDE thermal quench, but this phase is not clearly matched by preliminary attempts to fit to the conducted heat load phase. Clear indications of plasma infra-red (IR) emission are observed both before and during the disruptions. This IR emission can affect calculation of disruption heat loads; here, the time decay of post-disruption IR signals is used to correct for this effect.
Basic research on myocarditis: superb but unrequited.

Considerable progress has been made at the basic research level in our understanding of the molecular pathophysiology of myocarditis, as exemplified by the eloquent report of Weithauser et al. [(1)][1] in this issue of the Journal . But, at the clinical level, myocarditis has been strikingly
Some Problems with the Concept of “Normal Aging”

The normal human life cycle has been discussed at length in the recent professional literature. We have been educated about the “passages” or “life transitions” that each individual experiences in the orderly sequence of roles, relationships and life events that most people experience. A central theme in this adult development literature is the idea that there are in each life certain predictable and normal challenges to emotional well-being. These are sometimes called “normative crises” with the implication that certain intrapsychic conflicts are the normal results of certain developmental changes. Thus the aggression of a “terrible twos” toddler, the moodiness of the volatile pubescent adolescent and the grim and sometimes humorless overwork of the young adult climbing the career ladder are all viewed as inevitable and even adaptive states of affairs.
Finding patterns and learning words: Infant phonotactic knowledge is associated with vocabulary size

Native language statistical regularities about allowable phoneme combinations (i.e., phonotactic patterns) may provide learners with cues to support word learning. The current research investigated the association between infants' native language phonotactic knowledge and their word learning progress, as measured by vocabulary size. In the experiment, 19-month-old infants listened to a corpus of nonce words that contained novel phonotactic patterns. All words began with "illegal" consonant clusters that cannot occur in native (English) words. The rationale for the task was that infants with fragile phonotactic knowledge should exhibit stronger learning of the novel illegal phonotactic patterns than infants with robust phonotactic knowledge. We found that infants with smaller vocabularies showed stronger phonotactic learning than infants with larger vocabularies even after accounting for general cognition. We propose that learning about native language structure may promote vocabulary development by providing a foundation for word learning; infants with smaller vocabularies may have weaker support from phonotactics than infants with larger vocabularies. Furthermore, stored vocabulary knowledge may promote the detection of phonotactic patterns even during infancy.
Spatially Multiplexed Fiber-optic SLM Microscopy for Applications of Optogenetics

A spatially multiplexed fiber-optic SLM microscopy for simultaneous cellular imaging and spatio-temporal photostimulation of multiple brain regions is presented. Our system utilizes a digital micromirror device (DMD) for patterned illumination and a tri-furcated fiber bundle.
Reproductive Response of Coleomegilla maculata (Coleoptera: Coccinellidae) to Colorado Potato Beetle (Coleoptera: Chrysomelidae) Eggs

A laboratory study was conducted to quantify the preoviposition period, duration and frequency of oviposition, and the fecundity of Coleomegilla maculata DeGeer feeding on a range of Colorado potato beetle, Leptinotarsa decemlineata (Say), egg densities. L. decemlineata eggs are suitable prey for C. maculata egg production. A water and honey-Wheast mixture diet was not sufficient for C. maculata reproduction, but 28 - 48% of adults remained alive on this diet for up to 98 d. The preoviposition period was significantly shorter for C. maculata females feeding on pea aphids, Acyrthosiphon pisum (Harris), (5.8-6.8 d) than for females feeding on L. decemlineata eggs (11.3-23 d). At the lowest L. decemlineata egg density (2 eggs per day), females had significantly longer preoviposition periods than at the higher prey densities (5, 10, and >15 eggs per day). Interoviposition periods and the numbers of days on which females laid eggs were not different among diets. Fecundity among females feeding on the different diets averaged from 33.2 to 102.7 eggs and was not significantly different on the preimaginal diet of either A. pisum or L. decemlineata eggs. Results of this study indicate that C. maculata could reproduce and maintain its populations in potato fields when L. decemlineata eggs are scarce.
Coordination, Learning, and Coups:

This article proposes a theory of coups that centers around coordination and learning. The military is modeled as many officers who only want to join a coup if others join as well (i.e., coordinati...
Abstract 221:TP53mutations in serous tubal intraepithelial carcinoma, the putative precursor lesion of ovarian high-grade serous carcinoma

Proceedings: AACR 102nd Annual Meeting 2011‐‐ Apr 2‐6, 2011; Orlando, FL Somatic mutation of TP53 is the most common molecular genetic alteration in high grade serous carcinoma (HGSC) of the ovary, occurring in more than 95% of cases. As serous tubal intraepithelial carcinomas (STICs) have been proposed to be the most likely precursor of HGSC, we undertook a study to determine whether STICs harbor TP53 mutations as well. Mutations of TP53 have been reported in STICs and associated HGSC but that study was limited to 5 cases. We therefore performed TP53 mutational analysis in a larger series of STICs and concurrent HGSCs and correlated the mutational status with p53 immunoreactivity. Formalin-fixed paraffin-embedded tissue specimens were obtained from 18 HGSCs with concurrent STICs; 8 of them contained two discrete STICs. Approximately 1,000 cells from STIC and normal-appearing fallopian tubal epithelium were laser-capture microdissected, while HGSCs were manually microdissected. Genomic DNA was extracted, PCR amplified and sequenced. TP53 mutations were analyzed from exons 4 to 8. Immunohistochemistry (IHC) for p53 was performed in all the cases. TP53 mutations were detected in 15 (83.3%) of 18 HGSCs. Importantly, TP53 mutations were not detected in the corresponding FTE samples from the same patients, confirming they are somatic mutations in HGSCs. STIC and associated HGSC shared identical TP53 mutations in 15 (93.8%) of 16 patients including 7 who had two STICs. The discordant case showed TP53 mutation in the HGSC but not in two separate concurrent STICs. By IHC, all the cases demonstrated the same pattern of p53 immunoreactivity (either all positive or completely negative) except the case with wild-type TP53 in the STIC and mutant TP53 in the HGSC. By IHC the STIC was p53 negative and the HGSC p53 positive. The three TP53 wild-type HGSCs and their associated STICs exhibited undetectable nuclear p53 by IHC. In contrast, four p53-negative HGSCs contained mutant TP53 with either a deletion or an insertion mutation. Our findings provide cogent evidence that TP53 mutations occur in most STICs, and that both STIC and concurrent HGSC share the identical TP53 mutations in the majority of cases. Future molecular genetic studies are necessary to delineate the clonal relationship and tumor progression from STIC to HGSC. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 221. doi:10.1158/1538-7445.AM2011-221
Acute and late toxicity of bilateral orbital irradiation in the management of primary intraocular lymphoma

Primary intraocular lymphoma (PIOL) is a rare malignancy with poor outcomes. Concerns regarding toxicity lead some clinicians to exclude orbital radiation therapy (RT). We aimed to quantify the ocular toxicity of RT in 11 PIOL patients treated with chemoimmunotherapy and bilateral orbital RT (median 36 Gy). A multidisciplinary team, including an ocular oncologist, followed patients for a median of 42 months after RT. Common adverse events included dermatitis (100%), conjunctivitis (82%), xerophthalmia (64%), and keratopathy (45%). All phakic eyes developed cataracts (100%); correction resulted in good vision recovery. New, visually significant retinopathy was observed in only one eye (<5%) and affected a patient with preexisting diabetes. This report suggests that severe, vision-threatening complications following orbital RT are uncommon. In the absence of comorbidities, orbital RT should not be withheld due to fear of vision-threatening toxicity. The risk of toxicity may be augmented by comorbidities, so an individualized approach is recommended.
Oligopoly dynamic pricing: A repeated game with incomplete information

We consider an oligopoly dynamic pricing problem where the demand model is unknown and the sellers have different marginal costs. We formulate the problem as a repeated game with incomplete information. We develop a dynamic pricing strategy that leads to a Pareto-efficient and subgame-perfect equilibrium and offers a bounded regret over an infinite horizon, where regret is defined as the expected cumulative profit loss as compared to the ideal scenario with a known demand model. The resulting equilibrium also reveals a spontaneous collusion among a subset of sellers due to the difference in marginal costs among the sellers.
In memoriam: William Wallace Newby (1902–1977)

W. W. Newby, professor of biology at the University of Utah from 1927 to 1971, was renowned as a great teacher and a clear and forceful writer and for his meticulous research in invertebrate embryology. Ancillary skills were counseling (especially of premedical students), illustrating, wood crafting, and paper preserving. Some of his writings pertained to the history of research in the biological sciences at the University of Utah. His specialty areas in teaching were embryology and genetics, and he served as chairman of the Department of Genetics and Cytology from the year of its creation in 1948 until 1962. The most outstanding example of his research pertained to the early embryology of the echiuroid worm Urechis caupo .
Gender-inclusive Gatekeeping: How (Mostly Male) Predecessors Influence the Success of Female CEOs

Male-typed leadership schemas have been widely acknowledged as barriers to women’s success in leadership roles. We explore how local organizational agents and contexts enable women leaders to overcome these barriers and achieve success at the highest levels in firms. Specifically, we focus on chief executive officer (CEO) succession events and study how several facets of predecessor CEOs and the succession context combine to influence incoming women’s post-succession performance. We conduct a qualitative comparative case study of all CEO successions that involved female successors between 1989 and 2009 across the largest corporations in the United States. Our findings suggest that women’s success occurred when a confluence of local firm-level factors and attributes of the (mostly) male predecessors promoted gender-inclusive gatekeeping during succession. Our qualitative comparative analysis approach reveal three recipes for female success: “handing over the legacy,” “partnering the legacy,” and “turning a...
Towards precision nephrology: the opportunities and challenges of genomic medicine

The expansion of genomic medicine is furthering our understanding of many human diseases. This is well illustrated in the field of nephrology, through the characterization, discovery, and growing insight into various renal diseases through use of Next Generation Sequencing (NGS) technologies. This review will provide an overview of the diagnostic opportunities of using genetic testing in the clinical setting by describing notable discoveries regarding inherited forms of renal disease that have advanced the field and by highlighting some of the potential benefits of establishing a molecular diagnosis in a clinical practice. In addition, it will discuss some of the challenges associated with the expansion of genetic testing into the clinical setting, including clinical variant interpretation and return of genetic results.
After JCPOA: American grand strategy toward Iran

ABSTRACTIf grand strategy is a state's theory of how to produce security for itself, what should the U.S. grand strategy be toward Iran? This is an important question that has only grown since the ...
Gender Differences in Intellectual and Moral Development

When Samuel Johnson was asked, “Who is smarter, men or women?” he is reported to have answered, “Which man? Which woman?” (As quoted in Nicholson, 1984, p. 77). With this seemingly simple response, Johnson moved out of the traditionally dichotomous paradigm that has guided much of psychology’s exploration of gender differences. For decades, philosophers, historians, and social science researchers have focused on the differences between men and women, often entering their investigations with the implicit assumption that differences exist, and then attempting to explain these differences with anecdotal and/or empirical “evidence.” Psychological theory and research on intellectual and moral development have been no exception.
Neps in Ginned Lint: The Effect of Varieties, Harvesting, and Ginning Practices1

The effects of varieties, harvesting practices, and ginning techniques on the nep content of ginned lint were evaluated in a two year study in the Mississippi Delta. Neps increased more with lint cleaning during ginning than with harvesting practices or varieties. Two stages of lint cleaning increased the neps in ginned lint from 15.9 to 36.2 neps/645 cm2 of web. Differences caused by varieties were about equal to those caused by harvesting practices. The nep content was not significantly related to the number of seedcoat fragments, foreign matter, or grade.
Induction of parturition in the ewe

One-hundred and seventeen ewes were used in a study of induction of parturition. Ewes were treated with either 2 mg flumethasone (FLU), 15 mg prostaglandin F2 alpha-THAM salt (PGF) or physiological saline (control) on day 141 of gestation, as determined by dates of marking by rams. Eighty-nine percent of the ewes treated with FLU and 33% of the ewes treated with PGF lambed within 72 hr post-treatment. More (P less than .01) ewes treated with PGF or FLU lambed within 72 hr than did control ewes. The interval from treatment to parturition was shorter in FLU (P less than .01) and PGF (P less than .05) treated ewes than in ewes given saline.
Hailing the US job-seeker: origins and neoliberal uses of job applications

In every US city or college campus, it is possible to attend workshops designed to teach job seekers how to fashion the genre repertoire required to apply for a job. Over the past 15 years, these w...
Clinical Assessment of Postoperative Cognitive Decline

Neuropsychologists are occasionally called upon to evaluate patients who present with a history of cognitive decline following non-neurological surgery. While there is a large body of prospective cognitive outcome studies performed in surgical patients, there is a paucity of literature pertaining to patients who present for clinical evaluation of postoperative cognitive decline and a paucity of practice-related resources to guide neuropsychologists in performing evaluations in this patient population. This chapter aims to address this need by presenting an overview of mechanisms of intraoperative cerebral injury and setting forth a set of recommendations to aid clinical neuropsychologists in the clinical assessment of postoperative cognitive decline.
Treatment Duration and Associated Outcomes for Skin and Soft Tissue Infections in Patients With Obesity or Heart Failure.

Background Although existing literature supports durations of 5-7 days for skin and soft tissue infections (SSTIs), longer durations are commonly used. Obesity and heart failure (HF) have been associated with increased risk for treatment failure of SSTIs; however, whether prolonged antibiotic durations reduce the risk of treatment failure is unknown. We evaluated practice patterns for SSTIs in patients with obesity and/or HF and whether short antibiotic durations (≤8 days) were associated with treatment failure. Methods We performed a single-center, retrospective cohort study of inpatients between January 1, 2006, and December 30, 2016, with SSTIs based on International Classification of Diseases (ICD) coding, and obesity and/or HF. Charts were manually reviewed to collect demographic, clinical, treatment, and outcome data. Propensity score matching was used to estimate the risk of treatment failure between the 2 groups. Secondary outcomes included length of stay, 30-day readmission, and Clostridium difficile infection rates. Results A total of 207 patients were included. Forty-nine (23.7%) received a short antibiotic duration and 158 (76.3%) a long duration. The median duration of therapy (interquartile range [IQR]) was 7 (7-8) days in the short group and 14 (10-15) days in the long group. In the propensity score-matched cohort, 28 (28.6%) treatment failures occurred in the long group, as compared with 5 (10.2%) in the short group (P = .02), as well as a shorter length of stay (IQR) in the short- vs long-duration group (2 [2-3] vs 3 [2-5] days, respectively; P = .002). There was no difference in other secondary outcomes. Conclusions The majority of patients with obesity or HF received a longer antibiotic course for SSTIs; however, a longer antibiotic course was not associated with lower treatment failure rates. Higher failure rates in the long-duration group may be reflective of clinical decisions made in the face of diagnostic uncertainty and warrant further evaluation.
Impact and Cost-Effectiveness of Integrated Psychology Services in a Pediatric Endocrinology Clinic

Including psychology services in pediatric endocrinology clinics may improve patients’ adherence to diabetes management behaviors, and, subsequently, glycemic control; however, an evaluation of the impact and cost-effectiveness of this integration is needed. The change in HbA1c and cost-effectiveness of integrated psychology services, from the hospital and insurance provider perspectives, were evaluated using a linear effects model and Incremental Cost-Effectiveness Ratios (ICERs). Data from 378 patients with T1D (50% female; 65% Caucasian; M age = 12.0 years) were obtained via medical chart review (2241 appointments). Patients demonstrated significant improvements in HbA1c following clinic visits in which they met with psychology (b = − 0.16, p = 0.006). A larger proportion of the distribution of ICER values fall below the $1000/1% HbA1c threshold from both the insurance (89%) and hospital (94%) perspectives. These results indicate that providing integrated psychology services in the endocrinology clinic is highly beneficial from the patient, hospital, and insurance provider perspectives.
Applying Unoccupied Aircraft Systems to study human behavior in marine science and conservation programs

The declining costs of Unoccupied Aircraft Systems (UAS, aka drones), their ease of use, and their ability to collect high resolution data from a variety of sensors has resulted in an explosion of applications across the globe. Scientists working in the marine environment are increasingly using UAS to study a variety of topics, from counting wildlife populations in remote locations to estimating the effects of storms and sea level rise on shorelines. UAS also provide transformative potential to study the ways in which humans interact with and affect marine and coastal ecosystems, but doing so presents unique ethical and legal challenges. Human subjects have property rights that must be respected, and they have rights to privacy, as well as expectations of privacy and security that may extend beyond actual legal rights. Using two case studies to illustrate these challenges, we outline the legal and regulatory landscapes that scientists confront when people are their primary study subjects, and conclude with an initial set of legal best practices to guide researchers in their efforts to study human interactions with natural resources in the marine environment.
Feasibility and Acceptability of a Web-Based, Gender-Specific Intervention for Women with Substance Use Disorders

Background: Women face unique issues related to their substance use. Treatment programs that incorporate gender-specific components can to lead to enhanced outcomes for women with substance use disorders (SUDs). Nevertheless, most women receive treatment in mixed-gender SUD treatment programs that lack women-specific components. Programs cite lack of expertise and staff time as barriers to providing gender-specific care. Leveraging technology can address some of the challenges of providing gender-specific care in a mixed-gender setting by offering an accessible, cost-effective alternative to in-person services. Materials and Methods: We developed a gender-specific, web-based, psychoeducational intervention for women with SUDs as an addition to treatment as usual in a mixed-gender SUD treatment program. Next, we examined the feasibility and acceptability of this single-session intervention in a prepilot study with 30 women with SUDs. Based on these data, we refined the intervention and tested feasibility and acceptability with 60 women with SUDs. Results: Participants indicated a high level of satisfaction with the intervention. Satisfaction did not significantly differ by level of care (inpatient, partial hospitalization, or outpatient) or age, and was not associated with the number of previous treatment episodes. Participants highlighted the importance of addressing co-occurring disorders, trauma, and sexual abuse in SUD treatment for women. Conclusions: Women in this study found this web-based gender-specific intervention relevant regardless of their previous experience in treatment. Delivery of this intervention is feasible and has the potential to be a highly sustainable strategy for increasing exposure to gender-specific SUD components of care.
Biomimetic eye modeling & deep neuromuscular oculomotor control

We present a novel, biomimetic model of the eye for realistic virtual human animation. We also introduce a deep learning approach to oculomotor control that is compatible with our biomechanical eye model. Our eye model consists of the following functional components: (i) submodels of the 6 extraocular muscles that actuate realistic eye movements, (ii) an iris submodel, actuated by pupillary muscles, that accommodates to incoming light intensity, (iii) a corneal submodel and a deformable, ciliary-muscle-actuated lens submodel, which refract incoming light rays for focal accommodation, and (iv) a retina with a multitude of photoreceptors arranged in a biomimetic, foveated distribution. The light intensity captured by the photoreceptors is computed using ray tracing from the photoreceptor positions through the finite aperture pupil into the 3D virtual environment, and the visual information from the retina is output via an optic nerve vector. Our oculomotor control system includes a foveation controller implemented as a locally-connected, irregular Deep Neural Network (DNN), or "LiNet", that conforms to the nonuniform retinal photoreceptor distribution, and a neuromuscular motor controller implemented as a fully-connected DNN, plus auxiliary Shallow Neural Networks (SNNs) that control the accommodation of the pupil and lens. The DNNs are trained offline through deep learning from data synthesized by the eye model itself. Once trained, the oculomotor control system operates robustly and efficiently online. It innervates the intraocular muscles to perform illumination and focal accommodation and the extraocular muscles to produce natural eye movements in order to foveate and pursue moving visual targets. We additionally demonstrate the operation of our eye model (binocularly) within our recently introduced sensorimotor control framework involving an anatomically-accurate biomechanical human musculoskeletal model.
Patient characteristics of suspected mast-cell activation syndrome with sinonasal obstruction: a single institution experience.

Background Mast-cell activation syndrome (MCAS) is increasingly recognized. Sinonasal obstruction is common among these patients. There is a paucity of literature describing the characteristics of MCAS and treatment outcomes. Methods Retrospective review of 192 patients with nasal congestion July 2017 to May 2019 among 3 providers (1 allergist, 2 rhinologists) was conducted. Suspected MCAS criteria were as follows: (1) at least 2 recurrent severe symptoms in addition to nasal congestion: flushing, pruritus, urticaria, angioedema, wheezing, throat swelling, headache, hypotension, diarrhea; (2) clinical response to medications that target mast cell mediators. Quality of life (QOL) outcomes were quantified using the 22-item Sino-Nasal Outcome Test (SNOT-22). Results Thirty-two patients with nasal congestion were suspected of MCAS. The median age was 47 years; 24 of 32 were female; 13 of 32 had prior history of sinonasal surgery and 11 of 32 allergen immunotherapy. Out of 32, 19 had history of asthma, 10 drug allergy, 11 food allergy, and 10 anaphylaxis. The median number of medications targeting mast cell activation was 4 (range, 2-7). Eleven patients were offered surgery by a rhinologist after adequate medical management. Three of 32 patients showed elevation of serum tryptase. Fourteen completed pretreatment and posttreatment SNOT-22 (4/14 surgery, 10/14 medical management). Pretreatment score was 59.8 ± 6.2 (mean ± standard error [SEM]) and posttreatment score was 42.8 ± 6.7; the difference was statistically and clinically significant (p = 0.0015). Both groups showed a mean 17-point reduction. Conclusion A multidisciplinary approach to the treatment of sinonasal symptoms using both escalation of medical therapy and surgical approaches may improve QOL of patients with suspected MCAS. Consensus criteria for MCAS, which includes elevation in tryptase over baseline during an episode, may exclude the full spectrum of individuals with MCAS from potentially beneficial treatment.
Stress Induced Voiding Behavior of Electroplated Copper Thin Films in Highly Scaled Cu/low-k interconnects

Stress Induced Voiding (SIV) is strongly influenced by electroplating copper process (ECP) hardware setting: edge bevel removal (EBR, post plating cell of ECP hardware). The study indicated that more EBR will induce poor SIV performance. This phenomenon could be explained by the radius of curvature of a 300 mm patterned wafer. More outliers was observed at the higher level via. This suggested that the thermally induced stress in the via was increased with higher metallization layers. Regarding to the impact of metal width, only the widest metal width plus more EBR has highest RC drift, suggested that wider metal provides a sufficient vacancy source to form voids by more compressive stress gradient distribution beneath the via then cause higher RC drift.
Is a Prophylactic Central Compartment Neck Dissection Required in Papillary Thyroid Carcinoma Patients with Clinically Involved Lateral Compartment Lymph Nodes

The 2015 American Thyroid Association guidelines state that a prophylactic central compartment neck dissection (PCND) should be considered for patients with papillary thyroid carcinoma (PTC) and clinically involved lateral neck lymph nodes (cN1b). The purpose of our study was to determine the rate of central neck recurrence in select cN1b patients, with no evidence of clinically involved central compartment lymph nodes, treated without a PCND. After institutional review board approval, adult PTC patients with cN1b disease who were treated with a total thyroidectomy and lateral neck dissection were identified from an institutional database of 6259 patients who underwent initial surgery for well-differentiated thyroid carcinoma from 1986 to 2015. Patients with gross extrathyroidal extension, distant metastases, or no preoperative imaging were excluded. Patients with evidence of clinically involved central compartment lymph nodes, on preoperative imaging or intraoperative evaluation, also were excluded. A total of 152 cN1b patients were included and categorized into non-PCND and PCND groups. Central neck recurrence-free probability (CNRFP) was calculated using the Kaplan–Meier method and log-rank tests. One hundred three patients (67.8%) did not have a PCND. With a median follow-up of 65 months, the 5- and 10-year CNRFP was 98.4% in the non-PCND group and 93.6% in the PCND group (p = 0.133). Select PTC patients with cN1b disease but no evidence of clinically involved central compartment lymph nodes, on preoperative imaging and intraoperative evaluation, appear to have a low rate of central neck recurrence. These patients may not require or benefit from a PCND.
Modeling the potential impact of administering vaccines against Clostridioides difficile infection to individuals in healthcare facilities

Abstract Background A vaccine against Clostridioides difficile infection (CDI) is in development. While the vaccine has potential to both directly protect those vaccinated and mitigate transmission by reducing environmental contamination, the impact of the vaccine on C. difficile colonization remains unclear. Consequently, the transmission-reduction effect of the vaccine depends on the contribution of symptomatic CDI to overall transmission of C. difficile. Methods We designed a simulation model of CDI among patients in a network of 10 hospitals and nursing homes and calibrated the model using estimates of transmissibility from whole genome sequencing studies that estimated the fraction of CDI attributable to transmission from other CDI patients. We assumed the vaccine reduced the rate of progression to CDI among carriers by 25–95% after completion of a 3-dose vaccine course administered to randomly chosen patients at facility discharge. We simulated the administration of this vaccination campaign and tallied effects over 5 years. Results We estimated 30 times higher infectivity of CDI patients compared to other carriers. Simulations of the vaccination campaign produced an average reduction of 3–16 CDI cases per 1000 vaccinated patients, with 2–11 of those cases prevented among those vaccinated and 1–5 prevented among unvaccinated patients. Conclusions Our findings demonstrate potential for a vaccine against CDI to reduce transmissions in healthcare facilities, even with no direct effect on carriage susceptibility. The vaccine’s population impact will increase if received by individuals at risk for CDI onset in high-transmission settings.
Therapeutic plasma exchange: single-center experience in children with kidney disorders

Therapeutic plasma exchange (TPE) is used in kidney diseases as an adjunct treatment. Little has been described as to its effectiveness in kidney disorders in children. This study aimed to assess the safety, efficacy, and outcomes of patients who underwent TPE for kidney indications. Retrospective chart review of patients receiving TPE from 2010 to 2018 for kidney indications, such as antibody-mediated rejection, bone marrow transplant–associated thrombotic microangiopathy (TA-TMA), atypical hemolytic uremic syndrome, transplant recurrence of focal segmental glomerulosclerosis, and glomerulonephritis. Outcomes assessed were trends in kidney function, mortality, and progression to stage 5 chronic kidney disease (CKD 5). Significant hypocalcemia was defined as ionized calcium < 1 mmol/L. A total of 641 TPE procedures were performed on 47 patients (25 male). Average age was 12.8 ± 5.9 years. Median glomerular filtration rate (GFR) improved from baseline to end of TPE treatments (pre 44.9 (19.8, 79), end 56.1 (23, 98) [p = 0.02]). Ten out of 47 children developed CKD 5. Seven out of 47 patients died; 5 had TA-TMA. Initial 7 consecutive sessions were reviewed for complications. Among 335 procedures, 41 episodes of significant hypocalcemia were noted (12.2%); only 1 was symptomatic. Of the 26 episodes (7.7%) of allergic reactions, all were associated with the use of FFP; 5 were anaphylactic. No TPE-associated mortality was noted. TPE is a relatively well-tolerated useful adjunct therapy in children with kidney indications. The benefit of TPE has to be balanced with risks such as hypocalcemia and allergic reactions which can occur more frequently with FFP.