cssi/SciSciGPT-SciSciNet huggingface dataset:
Menopause, cessation of menses, vs. “menopause”, a primary brain disorder?

The “menopause” (not menopause, the cessation of menses) mechanism responsible for its symptom complex (Menopausal Symptom Complex) (or, Climacteric Syndrome) including chronic fatigue, fibromyalgia, depression, tension headache, cervical vertigo, sleep disturbances, irritability, anxiety/panic attacks, cognitive changes (decreased concentration to obsessional/delusional thought), decreased libido, and vasomotor dysfunction remains elusive. And MSC, other than vasomotor dysfunction, is not significantly altered by treatment with sex hormones (estrogen/progesterone), which have major neoplastic and vascular side effects. Thus at present, there are minimal indications for treatment with these compounds. Confusion between menopause and “menopause” (MSC) as well as research money made available by pharma advocating ERT/HRT (estrogen replacement therapy/hormone replacement therapy) has produced both therapeutic and research inertia. Presently, there would appear to be mismanagement of a symptom complex which infers primary brainlimbic system dysfunction and for which there is no correlation with falling sex hormone levels. Pharmacological modification of the proposed aberrant limbic circuitry responsible for the MSC has been successfully accomplished using specific NT/MMs (neurotransmission/modulation modifiers) i.e. a combination of alpha-1 and norepinephrine reuptake blockers, and thus providing initial elucidation of this particular brain pathophysiology as well as an efficient treatment of a problem affecting up to 60% of women ages 35 to 55. Specific NT/MMs capable of affecting a number of neurotransmitter/receptor types within limbic circuitry appear to reverse the MSC which includes chronic fatigue and fibromyalgia, pointing to aberrant limbic circuitry as their etiology as well.
High Reynolds number analysis of an axisymmetric afterbody with flow separation

The ability of a three-dimensional Navier-Stokes method, PAB3D, to predict nozzle afterbody flow at high Reynolds number was assessed. Predicted surface pressure coefficient distributions and integrated afterbody drag are compared with experimental data obtained from the NASA-Langley 0.3 m Transonic Cryogenic Tunnel. Predicted afterbody surface pressures matched experimental data fairly closely. The change in the pressure coefficient distribution with Reynolds number was slightly over-predicted. Integrated afterbody drag was typically high compared to the experimental data. The change in afterbody pressure drag with Reynolds number was fairly small. The predicted point of flow separation on the nozzle was slightly downstream of that observed from oilflow data at low Reynolds numbers and had a very slight Reynolds number dependence, moving slightly further downstream as Reynolds number increased.
Hormone replacement therapy and heart disease: replacing dogma with data.

In 1966, Dr Robert A. Wilson wrote an influential book entitled Feminine Forever that extolled the virtues of postmenopausal hormone replacement therapy (HRT).1 Over the next 3 decades, use of HRT to preserve the health and vitality of postmenopausal women became one of America’s most popular medical treatment paradigms. The enthusiasm for HRT was greatly enhanced by the perception that it could lower a woman’s risk for heart disease, perhaps by as much as 50%. This notion was fueled, in part, by the remarkably consistent finding from observational studies that postmenopausal users of HRT had substantially lower rates of cardiovascular events than non-users.2 Promising in vitro and animal model studies and favorable effects of HRT on cardiovascular risk factors added credibility to the observational study findings.3 By the mid-1990s, these cardiovascular and other data, coupled with effective relief of postmenopausal symptoms, helped make HRT the most frequently prescribed drug in the United States, despite the absence of any large, randomized clinical trials documenting its net clinical benefits or risks. See p 43 In 1998, however, the HRT paradigm began to crumble with the release of the Heart and Estrogen/progestin Replacement Study (HERS). In this, the first major randomized clinical trial of HRT for secondary prevention of heart disease, there was no overall benefit of hormone treatment, but there was an unexpected pattern of increased risk during the first year of follow-up.4 Since then, 7 additional randomized clinical trials, testing a variety of hormone replacement regimens, also found no benefit of HRT on anatomic or clinical manifestations of atherosclerosis in women with established cardiovascular disease.5–9b In many of these trials, there was a persistent suggestion that HRT might indeed increase cardiovascular risk. Debates about the validity, generalizability, and proper interpretation of these trials resulted in numerous …
Novel TFAP2B Mutations That Cause Char Syndrome Provide a Genotype-Phenotype Correlation

To elucidate further the role, in normal development and in disease pathogenesis, of TFAP2B, a transcription factor expressed in neuroectoderm, we studied eight patients with Char syndrome and their families. Four novel mutations were identified, three residing in the basic domain, which is responsible for DNA binding, and a fourth affecting a conserved PY motif in the transactivation domain. Functional analyses of the four mutants disclosed that two, R225C and R225S, failed to bind target sequence in vitro and that all four had dominant negative effects when expressed in eukaryotic cells. Our present findings, combined with data about two previously identified TFAP2B mutations, show that dominant negative effects consistently appear to be involved in the etiology of Char syndrome. Affected individuals in the family with the PY motif mutation, P62R, had a high prevalence of patent ductus arteriosus but had only mild abnormalities of facial features and no apparent hand anomalies, a phenotype different from that associated with the five basic domain mutations. This genotype-phenotype correlation supports the existence of TFAP2 coactivators that have tissue specificity and are important for ductal development but less critical for craniofacial and limb development.
The effect of habitual and experimental antiperspirant and deodorant product use on the armpit microbiome

An ever expanding body of research investigates the human microbiome in general and the skin microbiome in particular. Microbiomes vary greatly from individual to individual. Understanding the factors that account for this variation, however, has proven challenging, with many studies able to account statistically for just a small proportion of the inter-individual variation in the abundance, species richness or composition of bacteria. The human armpit has long been noted to host a high biomass bacterial community, and recent studies have highlighted substantial inter-individual variation in armpit bacteria, even relative to variation among individuals for other body habitats. One obvious potential explanation for this variation has to do with the use of personal hygiene products, particularly deodorants and antiperspirants. Here we experimentally manipulate product use to examine the abundance, species richness, and composition of bacterial communities that recolonize the armpits of people with different product use habits. In doing so, we find that when deodorant and antiperspirant use were stopped, culturable bacterial density increased and approached that found on individuals who regularly do not use any product. In addition, when antiperspirants were subsequently applied, bacterial density dramatically declined. These culture-based results are in line with sequence-based comparisons of the effects of long-term product use on bacterial species richness and composition. Sequence-based analyses suggested that individuals who habitually use antiperspirant tended to have a greater richness of bacterial OTUs in their armpits than those who use deodorant. In addition, individuals who used antiperspirants or deodorants long-term, but who stopped using product for two or more days as part of this study, had armpit communities dominated by Staphylococcaceae, whereas those of individuals in our study who habitually used no products were dominated by Corynebacterium. Collectively these results suggest a strong effect of product use on the bacterial composition of armpits. Although stopping the use of deodorant and antiperspirant similarly favors presence of Staphylococcaceae over Corynebacterium, their differential modes of action exert strikingly different effects on the richness of other bacteria living in armpit communities.
Issues in the Prediction of Inelastic Behavior in Bridges during Earthquakes

AbstractWith the continuing development of displacement-based and performance-based seismic design principles in the bridge engineering community comes the need to address issues that have historically been omitted from, or else treated in a vague manner within, bridge design specifications. It is likely that future design provisions will lead engineers to conduct more refined analyses compared to those currently adopted in some cases. This paper discusses four areas in the prediction of inelastic behavior in bridges, two on the capacity side and two on the demand side. On the capacity side, (1) choice of element type, force based or displacement based, and (2) effects from geometric nonlinearities are discussed. On the demand side, (1) differences between building design spectra and bridge design spectra are discussed, and (2) issues related to viscous damping levels adopted for nonlinear analysis are brought to the attention of practicing engineers.
Education of Civil Engineers: A Symposium: Training for Civil Engineering

The presenttrend of engineering education is toward more technical courses in the basic sciences narrowly pointed toward careers in research and development in the manufacturing industries. Because...
Posttransfusion Detection of Donor Red Cell Abnormalities

After the transfusion of packed red cells, two pediatric patients showed unexpectedly decreased mean corpuscular volumes (MCVs), increased red cell distribution widths (RDWs), and visible alterations in their red cell histogram patterns. Further investigation of the donor units involved showed that both children had received red cells that were extremely microcytic (MCVs of 58.4 and 63.9 fL, respectively). Subsequent laboratory studies of blood from these two donors showed that both were iron deficient and that one of the donors also had the hemoglobin electrophoresis pattern characteristic of β-thalassemia trait.
Mutation profiling of thyroid liquid-based fine needle aspirations improves diagnostic accuracy

Fine needle aspiration (FNA) is widely recognized as a reliable diagnostic method to evaluate thyroid nodules. Recently use of molecular biomarkers was proposed to improve pathologic accuracy. We evaluated feasibility and performance of molecular analysis in liquid-based FNA (LB-FNA) with indeterminate cytology. Mutation profiling of NRAS, HRAS and BRAF was performed on residual material from LB-FNA of 215 cases including 83 atypia of undetermined significance (AUS), 72 follicular neoplasms (FN), 46 suspicious for malignancy (SM), and 14 malignant (M). Forty-eight (22%) cases were mutated. Twenty-four cases presented a RAS mutation (19 NRAS and 5 HRAS) (11 AUS, 6 FN, and 7 SM) and 24 were carrying a BRAF mutation (1FN, 11 SM, and 12M). Surgical samples were available for 38 cases: 3 AUS, 14 FN, 13 SM and 8M. In the AUS category, 1 was a papillary carcinoma (PC) with NRAS mutation and 2 were benign (1 with NRAS mutation). In the FN category, 3 were malignant (1 with BRAF and 1 with HRAS mutation) and 11 benign (1 with HRAS and 1 with NRAS mutation). In the SM group, 10 were PC (3 with NRAS mutation and 5 with BRAF mutation) and 3 benign (no mutation). In the M group, all were PC with BRAF mutation. In conclusion, mutation profiling of BRAF and RAS can be successfully performed on residual material of thyroid LB-FNA and could improve the diagnostic accuracy of FNA.
Single Turnover Measurements of Nanoparticle Catalysis Analyzed with Dwell Time Correlation Functions and Constrained Mean Dwell Times

Single turnover measurements of a fluorogenic reaction at the surface of a nanoparticle provide a detailed view of reaction dynamics at a catalyst with multiple heterogeneous active sites. This picture must be extracted from a fluorescence trajectory of one particle, which records individual reaction and desorption events. We have previously proposed analyzing fluorescence trajectories with constrained mean dwell times in either light or dark states, which are averaged over a subensemble of events in which the dwell time in the previous state satisfies a criterion of being less than or greater than a specified time. We have shown that these quantities can be used to distinguish between correlated and independent fluctuations at multiple active sites. Here we show that this analysis is complementary to calculating dwell time correlation functions, whose decay with turnover index quantifies dynamical disorder in the underlying kinetics. We analyze a measured fluorescence trajectory from a gold nanoparticle in terms of both constrained mean dwell times and dwell time correlation functions. The analysis demonstrates that the minimal kinetic model with discrete states that is qualitatively consistent with the data allows active sites to fluctuate among at least three substates with distinct adsorption and reaction rates.
Challenges in the management of osteoporosis and vitamin D deficiency in HIV infection

Until 2013, the National Osteoporosis Foundation guidelines did not include HIV infection and highly active antiretroviral therapy as osteoporosis risk factors that should trigger dual-energy x-ray absorptiometry (DEXA) screening for low bone mineral density (BMD) in older adults, but numerous data indicate that individuals with HIV infection are at early and increased risk for osteoporosis and fracture. For this reason, experts support the use of DEXA screening for HIV-infected postmenopausal women and men older than 50 years. Factors contributing to increased risk of low BMD in individuals with HIV infection include inflammation, effects of antiretroviral therapy, and numerous patient risk factors, including vitamin D deficiency. Workup for low BMD should include assessment for fracture risk and secondary causes of low BMD, including vitamin D deficiency, hyperparathyroidism, subclinical hyperthyroidism, hypogonadism, and phosphate wasting. Bisphosphonates are the preferred treatment to prevent fracture in low BMD but are not appropriate for treating osteomalacia, which is characterized by vitamin D deficiency and phosphate wasting. This article summarizes a presentation by Todd T. Brown, MD, PhD, at the IAS-USA continuing education program held in Atlanta, Georgia, in April 2013.
Immunology: Current and Future Technology Assessment

Recent developments in light scattering immunoassays, enzyme immunoassays, fluoroimmunoassays, and chemiluminescence immunoassays are discussed. Projections of the practical applications of the newer methods and the use of monoclonal antibodies in diagnostics are explored. New techniques with improved sensitivity and specificity herald even greater future growth in the field of immunology.
Oral traditions: a contextual framework for complex science concepts—laying the foundation for a paradigm of promise in rural science education

The overarching goal of this paper is to bring a diverse educational context—rural sayings and oral traditions situated in ecological habitats—to light and emphasize that they need to be taken into consideration regarding twenty-first century science education. The rural sayings or tenets presented here are also considered alternative ways of learning and knowing that rural people (elders and children) acquire outside of school in rural places of home and habitat. Throughout this paper we explore the complex nature of rural sayings or tenets that have been shared by community elders and examine their historic scientific roots. In so doing, we uncover a wealth of information regarding the diverse rural sociocultural and ecological connections and the situated macro and micro-contexts from which these tenets arise. We argue for a preservation and educational revitalization of these tenets for current and future generations. We show how this knowledge both augments and differs from traditional western science and science curricula by illuminating the ways in which oral traditions are embedded in place, people, memory and culture. We close by presenting an alternative paradigm for science education that incorporates pluralism as a means to enrich current place-based pedagogies and practices. We suggest that in order to tackle the complex problems in this new age of the Anthropocene, revitalizing elders' wisdom as well as valuing rural children’s diverse knowledge and the inherent connectivity to their habitats needs be cultivated and not expunged by the current trends that standardize learning. As stated in the call for this special issue, “rurality has a real positionality” and much can be learned from individual and unique rural contexts.
Efficient Clock Synchronization in Wireless Sensor Networks

An improved approach, called receiver only synchronization (ROS), relative to timing synch protocol for sensor networks (TPSN) was devised based on a two-way timing message exchange mechanism between two nodes. In ROS, all the nodes in their transmission range overhear the messages and adjust their clock parameters without having to communicate by themselves, hence saving a lot of energy. In this paper, we are proving that in ROS, one-way timing message transmission from the root node to the neighboring nodes located within its transmission range is superior to the two-way timing message exchange. Also, we are showing that choosing the more accurate model instead of the linear regression model yields further performance gains for the clock parameters estimation.
The genus Vanda (Orchidaceae: Aeridinae) in the Philippines: two new species and a key to the species in the archipielago

Two Philippine Vanda species long confused with the Javanese species V. limbata and V. helvola are here described as V. mariae and V. cootesii. A key to the genus Vanda in the Philippines is provided.
Monolithically integrated unidirectional circulators utilizing non-hermiticity and nonlinearity on inp

We demonstrate unidirectional monolithically integrated 4×4 optical circulators operating at 1.55 μm on InP. By exploiting the interplay between non-Hermiticity and nonlinearity, an isolation exceeding 20dB is experimentally observed with pulsed inputs.
Sexual violence in the college population: a systematic review of disclosure and campus resources and services.

Aims and objectives To synthesise research examining college student sexual violence disclosure and campus sexual violence resources and services. Background Recently, the issue of sexual violence within the college population has garnered attention worldwide. The prevalence of sexual violence within college students is alarmingly high. Survivors often experience negative outcomes (e.g. health-related consequences, impact on education). Efforts have been made to address this significant public health concern. Design Systematic review of published literature. Methods Studies were identified through systematic searches of PubMed, CINAHL and PsycInfo of articles published between January 2010–February 2015. A total of 672 articles were identified. After screening, 16 articles were included in this review. Results A lack of consistency in how sexual violence was referred to and measured was identified. Research on college student sexual violence disclosure has primarily been conducted in six areas: (1) informal disclosure, (2) formal disclosure, (3) friends’ perceptions of disclosure, (4) process/effects of disclosure on the survivor, (5) barriers to disclosure and (6) social support in the disclosure process. Research related to campus sexual violence resources and services has primarily focused on: (1) students’ knowledge, (2) students’ utilization and (3) students’ suggestions. Synthesised findings are presented. Conclusions Sexual violence impacts college student survivors and the campus community as a whole. To appropriately assist/address sexual violence, a thorough understanding of college student sexual violence disclosure and campus sexual violence resources/services is necessary. Suggestions for researchers, colleges and nurses are provided. Relevance to clinical practice Nurses who serve students, especially those at on-campus student health centres, are opportunely placed to address sexual violence. Findings highlight the need for nurses to use consistent definitions of sexual violence when identifying survivors. Nurses should take measures to increase disclosure and promote sexual violence resources/services provided by their facility. Additional suggestions for nurses are provided.
Scatter Search to Generate Diverse MIP Solutions

An objective function often is only a rough approximation of the actual goals of the organization and its stakeholders. Consequently, an optimal solution may be no more interesting than other solutions that provide good values. Beyond this, a set of “good” solutions whose members have diverse characteristics can be significantly more valuable for practical analysis and planning than any single, “best” solution. Yet the challenge of systematically uncovering such a diverse set of solutions, or even postulating what its defining features may be, has been conspicuously neglected. We address this challenge for 0-1 mixed integer programming problems and provide demonstrations of the computational efficiency of our approach.
Experiences with SCRAMx alcohol monitoring technology in 100 alcohol treatment outpatients

Background Transdermal alcohol monitoring technology allows for new research on alcohol use disorders. This study assessed feasibility, acceptability, and adherence with this technology in the context of two clinical research trials.
Management of patients with pain and severe side effects while on intrathecal morphine therapy: A case study.

Abstract Background and aims The use of intrathecal morphine therapy has been increasing. Intrathecal morphine therapy is deemed the last resort for patients with intractable chronic non-cancer pain (CNCP) who failed other treatments including surgery and pharmaceutical interventions. However, effective treatments for patients with CNCP who “failed” this last resort because of severe side effects and lack of optimal pain control remain unclear. Methods and results Here we report two successfully managed patients (Ms. S and Mr. T) who had intractable pain and significant complications years after the start of intrathecal morphine therapy. The two patients had intrathecal morphine pump implantation due to chronic consistent pain and multiple failed surgical operations in the spine. Years after morphine pump implantation, both patients had significant chronic pain and compromised function for activities of daily living. Additionally, Ms. S also had four episodes of small bowel obstruction while Mr. T was diagnosed with end stage severe “dementia”. The successful management of these two patients included the simultaneous multidisciplinary approach for pain management, opioids tapering and discontinuation. Conclusion The case study indicates that for patients who fail to respond to intrathecal morphine pump therapy due to side effects and lack of optimal pain control, the simultaneous multidisciplinary pain management approach and opioids tapering seem appropriate.
Tissue Engineering as a Minimally Invasive Method

As the field of tissue engineering enters a phase of clinical translation, there is a need to consider the surgical principles for transplantation of engineered biologic organs and tissues, which have traditionally been constructed with harvested cells seed on scaffolds and cultured in laboratory bioreactors. The methods of minimally invasive surgery should be an important component of clinical translation of tissue engineering techniques, which have been verified in vitro. This chapter will serve to illustrate how in situ tissue engineering can be used to harness the body’s ability to regenerate through the process of cell homing, an innate self-healing mechanism to recruit stem cells to injured or diseased tissues. By employing the body as a bioreactor, this technique of tissue engineering can be considered a minimally invasive method.
General strategies for effective capture and separation of noble gases by metal–organic frameworks

In this frontier article, we provide a brief overview of recent progress in capture and separation of noble gases by microporous metal–organic framework-based adsorbents, with an emphasis on xenon and krypton. Our discussions include separation mechanisms and strategies applied to enhance the MOF performance. Existing issues are also reviewed and potential solutions are proposed.
Outcome and undertreatment of mitral regurgitation: a community cohort study

Summary Background Mitral regurgitation is the most common valve disease worldwide but whether the community-wide prevalence, poor patient outcomes, and low rates of surgical treatment justify costly development of new therapeutic interventions remains uncertain. Therefore, we did an observational cohort study to assess the clinical characteristics, outcomes, and degree of undertreatment of mitral regurgitation in a community setting. Methods We used data from Mayo Clinic electronic health records and the Rochester Epidemiology Project to identify all cases of moderate or severe isolated single-valvular mitral regurgitation (with no other severe left-sided valvular disease or previous mitral surgery) diagnosed during a 10-year period in the community setting in Olmsted County (MN, USA). We assessed clinical characteristics, mortality, heart failure incidence, and results of cardiac surgery post-diagnosis. Findings Between Jan 1, 2000, and Dec 31, 2010, 1294 community residents (median age at diagnosis 77 years [IQR 66–84]) were diagnosed with moderate or severe mitral regurgitation by Doppler echocardiography (prevalence 0·46% [95% CI 0·42–0·49] overall; 0·59% [0·54–0·64] in adults). Left-ventricular ejection fraction below 50% was frequent (recorded in 538 [42%] patients), and these patients had a slightly lower regurgitant volume than those with an ejection fraction of 50% or higher (mean 39 mL [SD 16] vs 45 mL [21], p Interpretation In the community, isolated mitral regurgitation is common and is associated with excess mortality and frequent heart failure postdiagnosis in all patient subsets, even in those with normal left-ventricular ejection fraction and low comorbidity. Despite these poor outcomes, only a minority of affected patients undergo mitral (or any type of cardiac) surgery even in a community with all means of diagnosis and treatment readily available and accessible. This suggests that in a wider population there might be a substantial unmet need for treatment for this disorder. Funding Mayo Clinic Foundation.
Risk Factors for Perioperative Blood Transfusions in Adult Spinal Deformity Surgery.

Objective Adult spinal deformity (ASD) surgery is associated with a high rate of perioperative blood transfusions, and it is important to understand the risk factors for perioperative blood transfusions to implement strategies to reduce transfusions. The aim of this study was to identify independent risk factors of perioperative blood transfusions in patients undergoing surgery for ASD. Methods A retrospective cohort study was performed using the American College of Surgeons National Surgical Quality Improvement Program database from 2010 to 2014. Adult patients undergoing surgery for ASD were separated into 2 cohorts based on whether they received a perioperative blood transfusion. Univariate and multivariate regression models were used to identify risk factors for blood transfusion. Results In our cohort of 5805 patients, 27.1% received a blood transfusion. Multivariate regression analysis showed that patient-specific risk factors were age 65 years or older (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.49–2.03; P Conclusions Recognition of patient- and surgery-specific risk factors for perioperative blood transfusion is important to identify patients who are at high risk and to implement strategies to minimize intraoperative blood loss and decrease healthcare costs.
Assessing Targeted AIDS Prevention in Male and Female Prostitutes and their Clients

Prostitution can be defined as the exchange of sexual services for money or things of monetary value, such as drugs (1). Prostitution can play a role in the transmission of sexually transmitted agents, such as human immunodeficiency virus (HIV). One of the first reports of HIV antibody in female prostitutes suggested extremely high rates of infection. According to evidence reported from Ngoma, Rwanda, in 1985, 29 (88%) of 33 female prostitutes who had been seen at a sexually transmitted disease (STD) clinic and 7 (28%) of 25 male clients of female prostitutes were infected with HIV (2). This chapter presents the following points: 1) to describe the prevalence of HIV antibody in prostitutes and their clients tested in different parts of the world during 1985–1989; 2) to present public health interventions that might interrupt HIV transmission to and from prostitutes; and 3) to look at the effects of various interventions on self-reported sexual and preventive health behaviors, HIV seroprevalence, and the incidence of HIV or other sexually transmitted infections.
The Staffing Conference in Pediatric Oncology

Cancer in children is a very different reality now from what it was only a few decades ago. Instead of cancer being an invariably fatal disease, it is now a disease in which biological cure is the norm. The long-term survival rate varies among cancers, but the overall cure rate approximates 60%. One in 600 children between birth and 15 years of age acquires some form of neoplastic disease (Young and Miller, 1975). Therefore, in approximately 10 years, one in 1000 individuals reaching the age of 20 will be a survivor of childhood cancer and its therapy (Meadows, Krejmas, and Belasco, 1980). We must, therefore, be concerned not only with effective therapy but also with the effects of our therapy. There is a significant medical cost of cure and that cost should be taken into consideration in designing new therapies. However, there is also a documentable psychological cost of cure (Zwartes, 1980).
Association between time of day and performance, indications, and outcomes of obstetric interventions among nulliparous women delivering at term.

The objective of this study is to determine whether there is an association between delivery time and obstetric interventions, as well as maternal and perinatal outcomes. Retrospective cohort study of nulliparous women delivering singleton, vertex, live births at ≥37 weeks gestation at a single center from 2014 to 2015. Nighttime deliveries were designated as those occurring between 18:00 and 05:59 h. The primary outcomes were obstetrical interventions (cesarean delivery, operative vaginal delivery, episiotomy). Secondary outcomes included indications for operative deliveries, as well as maternal and perinatal outcomes. Of 7691 women eligible for inclusion, 3707 (48.2%) delivered during the nighttime. Women who experienced nighttime deliveries had no demographic or clinical differences compared with women delivering during the daytime. Women delivering during the nighttime had greater odds of cesarean delivery (OR 1.27, 95% CI 1.14–1.43) and operative vaginal delivery (OR 1.83, 95% CI 1.20–2.78). Women who delivered at night were also more likely to have neonates with a 5 min Apgar score <7 (OR 1.59, 95% CI 1.08–2.32) and umbilical artery pH < 7.0 (OR 1.76, 95% CI 1.18–2.63). There were no differences observed in any of the other outcomes examined. Delivery during the nighttime is associated with alterations in some obstetric interventions and perinatal outcomes
In reply: Rapidly progressive pleural effusion January 2019

We thank Dr. Davidson for his comments. Indeed, the teaching points may appear inconsistent with the actual patient journey in this case. In the real world, physicians from different teams and specialties are involved in the care of a patient, and medical practice may not strictly adhere to
Fast and Low-Precision Learning in GPU-Accelerated Spiking Neural Network

Spiking neural network (SNN) uses biologically inspired neuron model coupled with Spike-timing-dependent-plasticity (STDP) to enable unsupervised continuous learning in artificial intelligence (AI) platform. However, current SNN algorithms shows low accuracy in complex problems and are hard to operate at reduced precision. This paper demonstrates a GPU-accelerated SNN architecture that uses stochasticity in the STDP coupled with higher frequency input spike trains. The simulation results demonstrate 2 to 3 times faster learning compared to deterministic SNN architectures while maintaining high accuracy for MNIST (simple) and fashion MNIST (complex) data sets. Further, we show stochastic STDP enables learning even with 2 bits of operation, while deterministic STDP fails.
Taxicab Geometry--A Non-Euclidean Geometry of Lattice Points.

DURING the past decade, much im portance has been placed on the structure of mathematical systems. Structure has been the byword in the construction of texts and courses. For this task the frame work of geometry has been found to be quite acceptable at the secondary level. The axiom system of Euclidean geometry is examined in depth, but usually very little attention is given to other axiom systems. Occasionally axiom systems are discussed per se, but examples are usually too difficult to develop (such as non Euclidean systems), too limited in de velopment (such as a finite geometry), or too trivial to create any interest. The purpose of this paper is to present a discrete geometric system that does not have these faults. It is a non-Euclidean geometry in which students can easily discover theorems, yet it is not necessarily a finite geometry. Further, it derives from everyday life, yet has results that can be slightly startling. Finally, it may provide fuel for class discussions during part of a period (such as the last ten minutes or so) for several weeks. An axiomatic system has undefined elements, undefined terms, and axioms. It may also assume certain properties of other systems, such as the real number or set-theoretic systems. In this statement of the taxicab geometry, the following are assumed:
Recalibration of cystatin C using standardized material in Siemens nephelometers

Cystatin C is a key GFR biomarker. Recently, Siemens recalibrated the assay based on certified reference material ERM-DA471/IFCC. The NIH-funded longitudinal chronic kidney disease in children (CKiD) study has > 3000 cystatin C measurements based on a pre-IFCC calibrator provided by Siemens. Since cystatin C values for CKiD are now standardized to IFCC certified reference material, it is important to relate the IFCC-calibrated results to the previous values so that there are no discontinuous results. We diluted cystatin C ERM-DA471/IFCC (5.48 mg/L) into buffer and compared results with predicted ones. We then updated the cystatin C application on our BN II nephelometer to provide results based on pre-IFCC and IFCC calibrations of CKiD specimens simultaneously. We assayed 51 previously analyzed sera and 62 fresh additional specimens. The predicted concentrations from the IFCC standard were consistently 17% higher than the measured values using the pre-IFCC calibration (y = 1.1686x). Similarly, the re-run and fresh sample concentrations were 17% higher via the IFCC calibration than by the pre-IFCC calibration (y = 1.168x). There was very high reliability in the measurements using the previous calibration for re-run specimens (0.99) and for 33 pristine specimens using IFCC calibration (0.99). We confirm the recalibration proposed by Siemens. To convert pre-IFCC results to IFCC-calibrated concentrations, the value is multiplied by 1.17. Conversely, one divides IFCC-calibrated results by 1.17 to estimate GFR via previously published pre-IFCC CKiD eGFR equations. For older adolescents, cystatin C has already been standardized and can be directly applied to the CKD-EPI equations.
Unidirectional luminescence from InGaN/GaN quantum-well metasurfaces

III–nitride light-emitting diodes (LEDs) are the backbone of ubiquitous lighting and display applications. Imparting directional emission is an essential requirement for many LED implementations. Although optical packaging1, nanopatterning2,3 and surface roughening4 techniques can enhance LED extraction, directing the emitted light requires bulky optical components. Optical metasurfaces provide precise control over transmitted and reflected waveforms, suggesting a new route for directing light emission. However, it is difficult to adapt metasurface concepts for incoherent light emission, due to the lack of a phase-locking incident wave. Here, we demonstrate a metasurface-based design of InGaN/GaN quantum-well structures that generate narrow, unidirectional transmission and emission lobes at arbitrary engineered angles. We further demonstrate 7-fold and 100-fold enhancements of total and air-coupled external quantum efficiencies, respectively. The results present a new strategy for exploiting metasurface functionality in light-emitting devices. Exploiting two-dimensional metamaterials, the direction of emission from InGaN/GaN quantum wells is engineered while simultaneously improving quantum efficiency.
Thermal stability of hafnium zirconium oxide on transition metal dichalcogenides

Abstract Ferroelectric oxides interfaced with transition metal dichalcogenides (TMDCs) offer a promising route toward ferroelectric-based devices due to lack of dangling bonds on the TMDC surface leading to a high-quality and abrupt ferroelectric/TMDC interface. In this work, the thermal stability of this interface is explored by first depositing hafnium zirconium oxide (HZO) directly on geological MoS2 and as-grown WSe2, followed by sequential annealing in ultra-high vacuum (UHV) over a range of temperatures (400–800 °C), and examining the interface through X-ray photoelectron spectroscopy (XPS). We show that the nucleation and stability of HZO grown through atomic layer deposition (ALD) varied depending on functionalization of the TMDC, and the deposition conditions can cause tungsten oxidation in WSe2. It was observed that HZO deposited on non-functionalized MoS2 was unstable and volatile upon annealing, while HZO on functionalized MoS2 was stable in the 400–800 °C range. The HZO/WSe2 interface was stable until 700 °C, after which Se began to evolve from the WSe2. In addition, there is evidence of oxygen vacancies in the HZO film being passivated at high temperatures. Lastly, X-ray diffraction (XRD) was used to confirm crystallization of the HZO within the temperature range studied.
Confessions of the half-caste, or wheeling strangers of here and everywhere

This essay reads two Othellos together – Shakespeare’s seventeenth-century play and Vishal Bhardwaj’s 21st-century film – to attend to the caste- and gender-based confessions that drive the plot of Omkara. Through close attention to selected scenes from the film, this work demonstrates that casteism, a phenomenon cemented by India’s colonial past and thus reflecting the subcontinent’s neo-colonial (instead of post-colonial) reality, along with entrenched misogyny and ableism, work together to precipitate the tragedy of Dolly and Omkara. In bringing these apparently distant texts together, and in its commitment to intersectional exploration of embodiment, this work is a deliberate exercise in such transtemporal and transcultural thinking that literary criticism should enable.
Management of septic non union and discrepancy of humerus in a child: A case report.

Abstract Introduction The management of large bone defect in the upper limb is fraught with difficulties and problems. It’s is a long course treatment which include many components: infection, osseous loosening and shortening. Case presentation We present our experience of an 12-years-old boy with septic non union of the proximal left humerus with length discrepancy of 6 cm treated with Ilizarov fixator(IL) followed by vascularized fibula graft (VFG) with a good clinical result without complications. Discussion The bone loss may be treated with allografts, bone transfer and bone substitute. Consideration of the quality of bed tissue and the size of the bone defect are condition to ensure a good result. Conclusion Ilizarov fixator is an attractive and the most used technique for solving the problem of discrepancy and stabilizing in the upper limb.
Motivations for Peer-Support Volunteering: Social Identities and Role-Identities as Sources of Motivation:

Motivations for volunteering described by functional theory are loosely related to the types and duration of these activities. The motivating effects of individuals’ social- and role-based identiti...
Violent death : resilience and intervention beyond the crisis

Restorative and Clinical Essentials. Raphael, Stevens, Dunsmore, Clinical Theories of Loss and Grief. Bonanno, Grief, Trauma, and Resilience. Salloum, Rynearson, Family Resilience After Violent Death. Lord, Spiritual Essentials. Currier, Neimeyer, Fragmented Stories. Armour, Meaning Making for Survivors of Violent Death. Chefetz, Considering Medication Use in the Wake of Traumatic Experience. Restorative and Clinical Interventions. Ochberg, Exorcising Ghosts. Shear, Gorscak, Simon, Treatment of Complicated Grief Following Violent Death. Murphy, Evidence-based Interventions for Parents Following Their Children's Violent Deaths. Rynearson, Correa, Favell, Saindon, Prigerson, Restorative Retelling After Violent Dying. Malkinson, Geron, Intervention Continuity in Posttraffic Fatality. Davies, Salloum, What About the Very Young Child? Cohen, Mannarino, Treating Childhood Traumatic Grief. Rynearson, Favell, Belluomini, Gold, Prigerson, Restorative Retelling with Incarcerated Juveniles. Community Outreach and Intervention After Disaster and Warfare. Benedek, Ursano, Mass Violent Death and Military Communities. Allen, Tucker, Pfefferbaum, Community Outreach Following a Terrorist Act. Shahani, Trish, Healing After September 11. Rasras, Mitwalli, Sehwail, Group Therapy for Palestinian Family Members After Violent Death. Rynearson, Closing Thoughts.
Enhancing diurnal cortisol regulation among young children adopted internationally: A randomized controlled trial of a parenting-based intervention.

Children who have been adopted internationally commonly experience institutional care and other forms of adversity prior to adoption that can alter the functioning of the hypothalamic–pituitary–adrenal (HPA) axis. In particular, internationally adopted children tend to have blunted diurnal declines compared to children raised in their birth families. The Attachment and Biobehavioral Catch-Up (ABC) intervention was developed to enhance young children's biological and behavioral regulation by promoting sensitive parenting. The current study used a randomized controlled trial to assess whether ABC improved the diurnal functioning of the HPA axis among 85 children who had been adopted internationally when they were between the ages of 4 and 33 months (M = 16.12). Prior to the intervention, there were no significant differences in diurnal cortisol production between children whose parents were randomly assigned to receive ABC and children whose parents were randomly assigned to receive a control intervention. After the intervention, children whose parents had received the ABC intervention exhibited steeper declines in cortisol levels throughout the day than children whose parents had received the control intervention. These results indicate that the ABC intervention is effective in enhancing a healthy pattern of diurnal HPA axis regulation for young children who have been adopted internationally.
Autonomous Vehicle Control Using Particle Swarm optimization in a Mixed Control Environment

This work examines effective ways of controlling autonomous vehicles on the roadway while human-operated vehicles remain in use. Particle Swarm optimization is used to control speed, gap, and braking of autonomous vehicles on a merge lane where human-operated vehicles are simulated using the Krauss car-following model. Experiments performed in a simulated environment tested various vehicle densities, ratios of autonomous versus Krauss-operated vehicles, and scenarios where the type of vehicle merging was adjusted. Metrics collected from the simulation include number of merges, collisions, the average merge lane speed, and the average highway or “nonmerging” speed. Results show that the autonomous vehicles are able to learn vehicle following and merging techniques to keep merges and speeds maximal, while keeping collisions minimal.
Copper(II) and lead(II) adsorption onto zinc sulfide nanoparticles effects of light, pH, time, temperature, and interferences

A ZnS nano-sorbent to remove copper(II) and lead(II) ions from aqueous solutions was prepared via a hydrothermal reaction and characterized by X-ray diffraction. The zinc sulfide nanoparticle size was determined to be 7.0 ± 0.22 nm. The effects of pH, light conditions, time, capacity, and interferences on the zinc sulfide ability to remove copper(II) and lead(II) ions from aqueous solutions were investigated. pH studies showed that pH 5 was the optimal value for zinc sulfide binding both copper(II) and lead(II) ions. Under ambient light, the binding of both ions occurred within the first 5 min. Binding capacities ranged from 116.2 to 243.9 mg/g for copper(II), 39.1 to 147.1 mg/g for lead(II) ions, and 36.1–79.4 mg/g for lead(II) ions in the dark over temperature range from 4 to 45 °C. The thermodynamic parameters showed that the binding process for both copper(II) and lead(II) ions was either spontaneous or close to equilibrium. Light conditions were also investigated in the context of cation interference and showed that the presence of hard cations had no effect on the binding of lead(II) ions. On the other hand, the presence of hard cations showed small decrease in the binding of copper(II) ions.
Use of De Novo Designed Peptides for the Study of Metalloproteins and Enzymes

De novo design of protein structure(s) is a useful technique for understanding the factors that influence metalloprotein structure and stability. We have designed a series of α- helical coiled coil proteins for the modelling of the trigonal Hg(II) site of the metalloregulatory protein mer R. The peptides Ac-G-(LKALEEK)4-GCONH2, and Ac-G-(LKALEEK)-(LKACEEK)-(LKALEEK)2-GCONH2 were designed to self-aggregate as three-helix bundles. These peptides have been shown to have pH dependent aggregation and stability characteristics. The cysteine substituted peptide converts to an exceptionally stable two-helix bundle when Hg(II) is bound. This example illustrates how metal ions may dictate peptide aggregation.
From Telemedicine to Telehealth to eHealth: Where Does mHealth Fit?

The field of telemedicine, which emerged more than 40 years ago, has evolved from one-way transmission of information primarily for the purpose of diagnosis and treatment monitoring to robust telecommunications systems that enable virtual engagement between patients and providers. The technology evolution was made possible by the advent of high-speed processing and broadband transmission innovations. A forthcoming driver, changes in reimbursement practices associated with the Affordable Care Act, may impel the implementation of applications to a level more closely aligned with what we can and should do via remote health care, than what we have been financially motivated to do in past years.