cssi/SciSciGPT-SciSciNet huggingface dataset:
Climate influences on whitebark pine mortality from mountain pine beetle in the Greater Yellowstone Ecosystem.

Extensive mortality of whitebark pine, beginning in the early to mid-2000s, occurred in the Greater Yellowstone Ecosystem (GYE) of the western USA, primarily from mountain pine beetle but also from other threats such as white pine blister rust. The climatic drivers of this recent mortality and the potential for future whitebark pine mortality from mountain pine beetle are not well understood, yet are important considerations in whether to list whitebark pine as a threatened or endangered species. We sought to increase the understanding of climate influences on mountain pine beetle outbreaks in whitebark pine forests, which are less well understood than in lodgepole pine, by quantifying climate–beetle relationships, analyzing climate influences during the recent outbreak, and estimating the suitability of future climate for beetle outbreaks. We developed a statistical model of the probability of whitebark pine mortality in the GYE that included temperature effects on beetle development and survival, precipitation effects on host tree condition, beetle population size, and stand characteristics. Estimated probability of whitebark pine mortality increased with higher winter minimum temperature, indicating greater beetle winter survival; higher fall temperature, indicating synchronous beetle emergence; lower two-year summer precipitation, indicating increased potential for host tree stress; increasing beetle populations; stand age; and increasing percent composition of whitebark pine within a stand. The recent outbreak occurred during a period of higher-than-normal regional winter temperatures, suitable fall temperatures, and low summer precipitation. In contrast to lodgepole pine systems, area with mortality was linked to precipitation variability even at high beetle populations. Projections from climate models indicate future climate conditions will likely provide favorable conditions for beetle outbreaks within nearly all current whitebark pine habitat in the GYE by the middle of this century. Therefore, when surviving and regenerating trees reach ages suitable for beetle attack, there is strong potential for continued whitebark pine mortality due to mountain pine beetle.
Shakespeare’s Poetic Theology

Although theological paradox is vital to the meaning of ‘The Phoenix and Turtle’, it is not a devotional poem, even if to call it ‘secular’ would be almost as misleading. George Santayana in ‘The Absence of Religion in Shakespeare’ concludes that one would hardly believe that he had a religion, because although religious sentiments are uttered in his work, they are not given ‘their original meaning’.1 The poet, with a few notable exceptions, gazes on the here rather than the hereafter. The recent ‘turn to religion’ in Shakespeare studies has in multiple and often contradictory ways addressed Santayana’s challenge. In light of this ongoing reassessment, one might still say that ‘The Phoenix and Turtle’ is not ‘Christian’, because even though in it Shakespeare evokes one of Christianity’s foundational beliefs, and even though some of its prominent liturgical elements are decidedly Christian, it does not constitute a testament of faith.
Class confrontations in archaeology

Archaeologist not only live class they also study it. Archaeology as a discipline serves class interests and as a profession, or occupation, it has its own class structure. The discipline of archaeology has, since its founding, primarily served middle-class interests. It has formed part of the symbolic capital that has been necessary for membership in the middle class during this century. Archaeology has traditionally reproduced itself in the university using a guild model of apprenticeship and mastery. In both the academy and in cultural resource management today this guild model has become an ideology that obscures the existence of an archaeological proletariat of teaching assistants, adjuncts, and field techs. The ideology justifies denying these archaeologists respect, a living wage, job security, and benefits. A seven step program is proposed to rectify the structural class inequalities of modern archaeology.
Stabilization of exponentially unstable discrete-time linear systems by truncated predictor feedback

Abstract Predictor state feedback solves the problem of stabilizing a discrete-time linear system with input delay by predicting the future state with the solution of the state equation and thus rendering the closed-loop system free of delay. The solution of the state equation contains a term that is the convolution of the past control input with the state transition matrix. Thus, the implementation of the resulting predictor state feedback law involves iterative calculation of the control signal. A truncated predictor feedback law results when the convolution term in the state prediction is discarded. When the feedback gain is constructed from the solution of a certain parameterized Lyapunov equation, the truncated predictor feedback law has been shown to achieve asymptotic stabilization of a system that is not exponentially unstable in the presence of an arbitrarily large delay by tuning the value of the parameter small enough. In this paper, we extend this result to exponentially unstable systems. Stability analysis leads to a bound on the delay and a range of the values of the parameter for which the closed-loop system is asymptotically stable as long as the delay is within the bound. The corresponding output feedback result is also derived.
Changes in Forest Composition in Ohio Between Euro-American Settlement and the Present

Abstract In Ohio Euro-American settlement in the late 18th and early 19th centuries subjected forests to large scale disturbances, including widespread clearance. In the subsequent two centuries, some of this land has reforested. To describe changes in forest composition since settlement, we used archival maps of U.S. Public Land Survey records to characterize forest composition just before large scale Euro-American settlement in 27 Ohio counties. We then compared this with modern composition patterns from the U.S. Forest Service's Forest Inventory Analysis. Presettlement forests displayed strong spatial structure and regional differentiation. Counties in northwest Ohio were dominated by beech (Fagus grandifolia; mean relative abundance: 26.9%), whereas southeast Ohio counties were dominated by oaks (Quercus spp.; 50.1%). Modern forests, however, had weaker spatial structure and were dominated by oak species in both regions (24.0% and 22.4%, respectively). Overall, we found a decrease in previously domina...
NAND Flash Design

A Solid-State-Disk is made up by a Flash controller plus a bunch of NAND Flash devices. This chapter focuses on design aspects of NAND chips. The information stored in each memory cell is fully analog because it is related to the number of electrons stored in the floating gate. When we program, erase or read, electrons must be injected, extracted and counted, respectively. All these operations require a mix of analog and digital circuits that need to be properly and timely driven. Starting from a generic floorplan of a NAND memory, we guide the reader through the main building blocks. First of all, we describe the logic part of the chip, from the embedded microcontroller, who is in charge of running all the internal algorithms, to the fast DDR interface. Counting the number of electrons in the floating gate is definitely one of the most challenging task, considering that has to be performed with few transistors: sensing techniques are described in Sect. 6.5. Programming and erasing floating gate cells require voltages higher than the chip power supply. Therefore, charge pumps are used to generate all the needed voltages within the chip. In multilevel storage, cell’s gate biasing voltages need to be very accurate and voltage regulators become a must. All these circuits are described in the High Voltage Management section. Last but not least, the row decoder is introduced. This circuit has the task of properly biasing each single wordline in the NAND array, transferring the regulated high voltages to the gate of the memory cell.
Does a Religious Transformation Buffer the Effects of Lifetime Trauma on Happiness

ABSTRACTA number of studies have examined religious transformations. But most of this work has been concerned with identifying different types of transformations and steps in the process of transformation. The current study was designed to examine the ways in which religious transformations may be associated with happiness. We take a novel approach toward the evaluation of this relationship. We argue that a religious transformation may be an important resource for coping with lifetime trauma. Two major findings emerge from our nationwide survey (N = 2,851). First, the data indicate that the magnitude of the relationship between lifetime trauma and happiness is reduced significantly for people who have had a religious transformation but not for those who have not had this type of religious experience. Second, the results reveal that the potential stress-related benefits of a religious transformation are more evident among younger adults than among middle-aged or older adults.
Hyperhomocysteinemia in pre-eclampsia: is routine screening rational?

Background: Hypertensive disorders complicate upto 5 to 10% of all pregnancies. Though the exact cause of pre-eclampsia is still undecided, maternal hyperhomocysteinemia has been implicated as a risk factor for pre eclampsia, placental abruption and other vascular diseases. The objectives of present study were to estimate the levels of serum homocysteine in antenatal patients and to study the above parameters in patients of pre-eclampsia. Methods: A prospective observational study was performed with 30 pre eclamptic patients and an equal number taken as control having comparable demographic characteristics. Level of homocysteine was measured by an enzymatic method, using Diazyme homocysteine 2 reagent enzymatic assay kit on Beckman coulter analyzer in all the patients. Obstetrics and neonatal outcomes were observed in all the patients. The statistical analysis was done using unpaired T test for determining level of significance. Results: Mean Serum homocysteine in the study group was 13.99±5.46 µmol/l and was 6.03±2.58 µmol/l in control group. This was statistically significant (p value 0.002). However the mean values of serum homocysteine did not correlate with severity of pre-eclampsia 14.32±6.72 µmol/l in mild pre-eclampsia and 13.60±3.77μmol/l in severe pre-eclampsia respectively (p value - 0.727). Conclusions: It appears that maternal serum homocysteine has a causal role in pathogenesis of pre eclampsia, however to recommend it as a routine test, larger studies are required.
Rapid Synthesis of Rhodium–Palladium Alloy Nanocatalysts

The chemistry of metastable RhPd alloys is not well understood, and well-characterized nanoparticle (NP) examples remain rare. Well-defined and near-monodisperse RhPd NPs were prepared in a simple one-pot approach by using microwave-assisted or conventional heating in reaction times as short as 30 s. The catalytic hydrogenation activity of supported RhPd NP catalysts revealed that short synthesis times resulted in the most-active and most-stable hydrogenation catalysts, whereas longer synthesis times promoted partial Rh-Pd core–shell segregation. Relative to Rh NPs, RhPd NPs resisted deactivation over longer reaction times. Density functional theory (DFT) was employed to estimate the binding energies of H and alkenes on (1 1 1) Rh, Pd, and Rh0.5Pd0.5 surfaces. The DFT results concurred with experiment and concluded that the alkene hydrogenation activity trend was of the order Pd<RhPd<Rh. Rh-to-Pd charge-transfer in the RhPd alloys was found to play an important role in modulating the H binding energy.
Photobleaching of YOYO-1 in Super-Resolution Single DNA Fluorescence Imaging

Super-resolution imaging of single DNA molecules via point accumulation for imaging in nanoscale topography (PAINT) has great potential to visualize fine DNA structures with nanometer resolution. In a typical PAINT video acquisition, dye molecules (YOYO-1) in solution sparsely bind to the target surfaces (DNA) whose locations can be mathematically determined by fitting their fluorescent point spread function. Many YOYO-1 molecules intercalate into DNA and remain there during imaging, and most of them have to be temporarily or permanently fluorescently bleached, often stochastically, to allow for the visualization of a few fluorescent events per DNA per frame of the video. Thus, controlling the fluorescence on–off rate is important in PAINT. In this paper, we study the photobleaching of YOYO-1 and its correlation with the quality of the PAINT images. At a low excitation laser power density, the photobleaching of YOYO-1 is too slow and a minimum required power density was identified, which can be theoretically predicted with the proposed method in this report.
Activity in the ventral medial prefrontal cortex is necessary for the therapeutic effects of extinction in rats

Poor response and high relapse rates remain problematic in the treatment of stress-related psychiatric disorders such as depression and post-traumatic stress disorder. Although mechanisms of pharmacotherapies are intensely studied, little is known about mechanisms of behavioral therapy that could inform improved treatments. We have previously demonstrated the therapeutic effects of extinction learning as a behavioral intervention modeling exposure therapy in rats. In the present study, we tested the hypothesis that activity in the ventral medial prefrontal cortex (vmPFC) during extinction is necessary for its therapeutic effects. The inhibitory Gi-coupled designer receptor exclusively activated by designer drug CaMKIIα-hM4Di was expressed in vmPFC before administering chronic unpredictable stress (CUS). vmPFC projection neurons were then inhibited during extinction treatment by administering clozapine-N-oxide. Coping behavior and cognitive flexibility were assessed 24 h later on the shock-probe defensive burying test and attentional set-shifting test, respectively. Replicating previous results, extinction reversed the CUS-induced deficits in coping behavior and cognitive flexibility. Inhibiting vmPFC during extinction blocked these therapeutic effects. Further, increasing vmPFC activity with the excitatory Gq-coupled designer receptor exclusively activated by designer drug hM3Dq 24 h before testing was sufficient to reverse the CUS-induced deficits. CUS reduced mPFC responsivity, assessed by measuring afferent-evoked field potentials in the mPFC, and this reduction was reversed by extinction treatment 24 h before testing. These results demonstrate the necessity of vmPFC activity in the therapeutic effects of extinction as a model of exposure therapy, and suggest that increased vmPFC activity induced by extinction is sufficient to produce lasting plastic changes that underlie its beneficial effects.SIGNIFICANCE STATEMENT Stress-related psychiatric disorders remain poorly treated. Psychotherapies can be effective, but their mechanisms remain unknown, hindering progress toward improved treatment. We used a rat model of behavioral therapy to identify potential targets for enhancing treatment. Fear extinction as a therapeutic behavioral intervention reversed stress-induced cognitive dysfunction and passive coping in rats, modeling components of stress-related psychiatric disease. Extinction also reversed stress-induced attenuation of mPFC responsivity. The therapeutic effects were prevented by blocking activity of glutamatergic neurons in the mPFC during extinction, and were mimicked by inducing activity in lieu of extinction. Thus, activity and plasticity in the mPFC underlie the beneficial effects of extinction on cognitive flexibility and coping behavior compromised by stress, and could be targets to enhance behavioral therapy.
Severe pectus excavatum with tracheal compression presenting with chronic cough

Abstract While pectus excavatum is the most common congenital chest wall deformity in children, indications for surgical repair are still debated among experts. Some centers require demonstration of physiologic criteria prior to repair, even in the face of significant anatomic compression. We present a case of a 16-year-old male with severe pectus excavatum who presented with a 3-year history of a chronic barking cough and exercise-induced shortness of breath. Radiographic imaging demonstrated compression of the trachea and bilateral mainstem bronchi secondary to severe pectus excavatum deformity. Despite his severe pectus deformity, preoperative physiologic testing demonstrated normal to near-normal cardiopulmonary function. Minimally invasive repair of the chest wall defect (modified Nuss procedure) provided rapid alleviation of symptoms, and a significant improvement in quality of life.
Microvascular Anastomosis: Proposition of a Learning Curve

Background Learning to perform a microvascular anastomosis is one of the most difficult tasks in cerebrovascular surgery. Previous studies offer little regarding the optimal protocols to maximize learning efficiency. This failure stems mainly from lack of knowledge about the learning curve of this task. Objective To delineate this learning curve and provide information about its various features including acquisition, improvement, consistency, stability, and recall. Methods Five neurosurgeons with an average surgical experience history of 5 yr and without any experience in bypass surgery performed microscopic anastomosis on progressively smaller-caliber silastic tubes (Biomet, Palm Beach Gardens, Florida) during 24 consecutive sessions. After a 1-, 2-, and 8-wk retention interval, they performed recall test on 0.7-mm silastic tubes. The anastomoses were rated based on anastomosis patency and presence of any leaks. Results Improvement rate was faster during initial sessions compared to the final practice sessions. Performance decline was observed in the first session of working on a smaller-caliber tube. However, this rapidly improved during the following sessions of practice. Temporary plateaus were seen in certain segments of the curve. The retention interval between the acquisition and recall phase did not cause a regression to the prepractice performance level. Conclusion Learning the fine motor task of microvascular anastomosis adapts to the basic rules of learning such as the "power law of practice." Our results also support the improvement of performance during consecutive sessions of practice. The objective evidence provided may help in developing optimized learning protocols for microvascular anastomosis.
The Role of the Gap Junction Protein Connexin32 in the Myelin Sheath

X-linked Charcot-Marie-Tooth disease (CMTX) is caused by mutations in the gap junction gene connexin32 (Cx32). To date, 89 different mutations have been found, including deletions, insertions, missense, and nonsense mutations, and at least two mutations in the non-coding region. Different mutations appear to have different effects on the synthesis and localization of Cx32 protein. Both myelinating Schwann cells and oligodendrocytes express Cx32 mRNA and protein, and the localization of Cx32 protein matches the location of putative gap junctions previously seen by freeze-fracture electron microscopy. In myelinating Schwann cells, Cx32 protein is found in incisures and paranodes. Preliminary data suggest that gap junctions form a radial channel that directly traverses the myelin sheath. It is plausible that mutations in Cx32 disrupt the gap junctions in the myelin sheath, thereby abolishing this radial pathway and leading to peripheral neuropathy.
Vignette Regarding Consortia: C-Path Institute

This is a vignette about biomarkers and about regulatory innovation. It is also about personal commitment and courage in FDA (Food and Drug Administration) champions and others who make change happen. It describes the setting up of the Critical Path Institute and the factors that enabled it to interact with multiple stake-holding parties to collaborate and work for regulatory change.
Anatomy of Cloacal Exstrophy

Cloacal exstrophy with an estimated incidence of 1 in 200–400,000, is the rarest and most severe form of the exstrophy epispadias complex.1,2 Prior to 1960 the multiple systemic defects found in association with this anomaly inevitably lead to death of the infant.3,4 Refinements in surgical technology, neonatal care, hyperalimentation and antibiotic therapy currently allow us to obtain survival rates in the range of 85–90%.1,5 To appropriately plan for the surgical reconstruction of these patients, the pediatric urologist, surgeon and radiologist managing these individuals must beware of the multiple anomalies that coexist with this entity. The purpose of this paper is to outline the associated congenital defects and review their impact on the surgical treatment and management of this patient population.
Models of Injury of Cardiovascular Membranes by Amphiphiles and Free Radicals

Current evidence from ultrastructural, biochemical and electrophysiological studies suggest that membrane damage is an early event in ischemic myocardial injury (1–3). Previous investigations (4–8) suggest that sarcolemmal, microsomal and lysosomal structural and functional integrity may be compromised by any one or combinations of mechanisms that may be active during ischemia. During ischemia, cellular membranes may be subjected to perturbations by accumulated lipid metabolites, elevated levels of free radicals and activated lipolytic enzymes. We have investigated the molecular nature of several injurious processes in vitro in an effort to determine the potential sequence of events leading to ischemic membrane damage. Incubation of highly purified hepatic lysosomes at acid pH results in loss of lysosomal latency and leakage of lysosomal lipases. When the sarcolemmal (SL) membranes from canine myocytes were incubated with the soluble lysosomal enzymes, the membrane phospholipids were differentially hydrolyzed. In the presence of a .02− driven (derived from dihydroxyfumarate) iron catalyzed-free radical generating system, the SL membrane fluidity was altered. The peroxidation of the SL membrane was accompanied by a selective loss of phospholipids and the membrane-bound Na,K-ATPase was also inactivated.
Chapter 9 – Introduction

Individually, the majority of primary neuromuscular disorders are rare diseases; however, in aggregate and those disorders secondary to systemic disease, such as diabetes, are a major contributor to the global burden of disease and lead to significant disability for an individual. The etiologies of disease compromising the peripheral nerve, neuromuscular junction, and muscle vary from specific gene defects to autoimmune attack to metabolic derangement. Frequently, the secondary consequences of a gene defect lead to inflammation or altered energy metabolism and therefore these diverse disorders have overlaps in their pathophysiology. The four chapters in this section provide detailed insights into the pathology of peripheral nervous system disease and provide insights into their human consequences.
Path Probability Method as Applied to Problems of Superionic Conduction

Different from superelectronic conduction, superionic conduction in ionic solids is closely related to a peculiar structural characteristic of crystals known as a substantial sublattice disorder or a “liquid sublattice.”1 The large ionic conductivity is due to a mass motion of a large number of diffusing ions in the liquid sublattice. The problems of superionic conduction can therefore be reduced to elucidating the following two fundamental problems: the origin which leads to the formation of such substantial sublattice disordering and the transport mechanism of ions in the substantially disordered sublattice. What we try here is to describe the characteristics of the mass motion of ions statistical mechanically when the characteristics of the “liquid sublattice” are specified. As such, the treatment is a generalization of the random walk theory of diffusion which is only applicable when the number of defects through which ions can move is extremely small.
Lumbar pseudomeningocele causing hydronephrosis.

AbstractBackground/Objective: Pseudomeningocele is most commonly the result of a rent in the meninges during spine surgery. Noniatrogenic causes exist but are rare. Pseudomeningoceles may heal spontaneously, but they may also slowly enlarge. They rarely present as a mass within the abdomen. The objective of this study was to present the first case report of hydronephrosis secondary to lumbar pseudomeningocele.Design: Single case report and literature review.Methods: Single case report.Results: This man had undergone extensive lumbar spine surgery for pain and spondylolisthesis. He subsequently developed a pseudomeningocele that caused hydronephrosis of the left kidney. He was treated with surgical intervention and had resolution of his hydronephrosis and his flank and groin pain. He also had improvement of his back pain.Conclusions: This report shows an unusual cause of hydronephrosis—a pseudomeningocele presenting as an abdominal mass that compressed the ureter.
Heterogeneous Multi-die Stitching: Technology Demonstration and Design Considerations

In this paper, a Heterogeneous Interconnect Stitching Technology (HIST) is reported. In the proposed approach, stitch-chips, which may be active or passive chips, are placed between the package substrate and concatenated 'anchor chips'. Fine-pitch Compressible MicroInterconnects (CMIs) are used to provide low-loss and robust interconnection between the anchor chips and the stitch-chips. The CMIs are also used to compensate for any package non-planarity and stitch-chip thickness variations, as one anchor chip may interface to multiple different stitch-chips at each of its edges. Electrical measurements of the assembled chips are reported and demonstrate robust interconnection. Integrated circuits in the HIST platform are thermally evaluated to investigate thermal challenges and opportunities for such multi-die packages. Impact of different parameters, including die-spacing, stitch-chip splitting, and die-thickness mismatch, for example, on the thermal profile are evaluated. Moreover, power delivery network analysis is performed for the HIST platform with focus primarily on the IR-drop as a function of the overlap area between the anchor dice and the stitch-chips.
Structural brain volume differences between cognitively intact ApoE4 carriers and non-carriers across the lifespan

Apolipoprotein E4 (ApoE4) is a prominent genetic risk factor for Alzheimer's disease. The purpose of this review is to explore differences in structural brain volume detected by magnetic resonance imaging between cognitively intact ApoE4 carriers and non-carriers across the lifespan (i.e., older adults, middle-aged adults, young adults, children and adolescents, and neonates). Consistent findings are found throughout various developmental stages. This area of research may elucidate the mechanisms by which ApoE4 influences risk of developing Alzheimer's disease. It could also inform potential treatment strategies and interventions for carriers of the ApoE4 allele.
MRI SPACE sequence confirmation of occluded MCA M2 dissection stump masquerading as a ruptured MCA aneurysm

Intracranial vascular pathologies often have overlapping clinical presentations. Dissected vessel occlusions and bifurcation aneurysms can appear similar on pretherapeutic imaging. The medical management of these two entities is drastically different. The patient is a 51-year-old man who presented with severe, sudden-onset headache. Initial presentation was consistent with a ruptured middle cerebral artery (MCA) aneurysm and surgical clipping was recommended. However, further review of radiographic findings could not definitively differentiate an aneurysmal origin of the symptoms as opposed to intracranial dissection followed by occlusion of the M2 branch of the MCA. MRI sampling perfection with application optimised contrasts using different flip angle evolution (SPACE) was performed and showed thin flow signalling distal to the dissected vessel stump confirming the diagnosis. Accurate diagnosis is a crucial step in directing treatment for intracranial vascular lesions. MRI SPACE is a simple tool in the diagnostic armamentarium to adequately direct treatment and avoid the potential for unnecessary interventions.
Does suturing tonsil pillars post-tonsillectomy reduce postoperative hemorrhage?: A literature review.

Abstract Objective Literature review comparing post-tonsillectomy hemorrhage in pediatric and adult patients with and without suturing tonsil pillars to investigate whether suturing tonsil pillars reduces the risk of post-tonsillectomy hemorrhage. Review methods Online journal databases were searched using the key phrases “post tonsillectomy hemorrhage”, “post tonsillectomy bleed”, and “tonsil pillar suture”. 10 published studies were found regarding tonsil pillar suturing, four directly related to postoperative bleeding and five focusing on postoperative pain reduction. There was one study that evaluated both pain and bleeding. The pain reduction studies were comprised of 225 patients while the postoperative bleeding studies included 3987 patients. Conclusions Suturing tonsil pillars after tonsillectomy may be beneficial after cold tonsillectomy. Implications for practice Post-operative bleeding is one of the most common complications that can result in increased patient distress and hospitalization. In this article, we provide a literature review of tonsil pillar suturing and post-tonsillectomy hemorrhage. Our study suggests suturing the tonsil pillars immediately post-tonsillectomy may reduce the risk of severe post-operative bleeding requiring return to the operating room for certain patients.
Predictors of postinjury acute respiratory distress syndrome: Lung injury persists in the era of hemostatic resuscitation.

BACKGROUNDAcute respiratory distress syndrome (ARDS) following trauma is historically associated with crystalloid and blood product exposure. Advances in resuscitation have occurred over the last decade, but their impact on ARDS is unknown. We sought to investigate predictors of postinjury ARDS in t
Imaging findings of Menkes disease, a radiographic mimic of abusive trauma

Menkes disease is a rare X-linked recessive disorder caused by impaired copper absorption and transport. Presented here is a case of a 12-week-old male who presented with hypotonia and multiple metaphyseal fractures. Further imaging and workup revealed a diagnosis of Menkes disease. While nonaccidental trauma is a much more common cause of metaphyseal bone fractures, encephalopathy, and subdural hematomas in infants, Menkes syndrome should be considered in the setting of corroborating signs and symptoms, as early diagnosis and treatment can delay progression of the disease.
Trends in United States emergency department visits and associated charges from 2010 to 2016.

Abstract Background Demographic shifts and care delivery system evolution affect the number of Emergency Department (ED) visits and associated costs. Recent aggregate trends in ED visit rates and charges between 2010 and 2016 have not been evaluated. Methods Data from the National Emergency Department Sample, comprising approximately 30 million annual patient visits, were used to estimate the ED visit rate and charges per visit from 2010 to 2016. ED visits were grouped into 144 mutually exclusive clinical categories. Visit rates, compound annual growth rates (CAGRs), and per visit charges were estimated. Results From 2010 to 2016, the number of ED visits increased from 128.97 million to 144.82 million; the cumulative growth was 12.29% and the CAGR was 1.95%, while the population grew at a CAGR of 0.73%. Expressed as a population rate, ED visits per 1000 persons increased from 416.92 in 2010 to 448.19 in 2016 (p value Conclusion The rate of ED visits per 1000 persons and the mean charge per ED visit increased significantly between 2010 and 2016. Mean charges increased for both high- and low-acuity clinical categories. Visits for the 5 most common clinical categories comprise about 30% of ED visits, and may represent focus areas for increasing the value of ED care.
Thermalization and its breakdown for a large nonlinear spin

Author(s): Kelly, Shane P; Timmermans, Eddy; Tsai, S-W | Abstract: By developing a semi-classical analysis based on the Eigenstate Thermalization Hypothesis, we determine the long time behavior of a large spin evolving with a nonlinear Hamiltonian. Despite integrable classical dynamics, we find the Eigenstate Thermalization Hypothesis for the diagonal matrix elements of observables is satisfied in the majority of eigenstates, and thermalization of long time averaged observables is generic. The exception is a novel mechanism for the breakdown of thermalization based on an unstable fixed point in the classical dynamics. Using the semi-classical analysis we derive how the equilibrium values of observables encode properties of the initial state. This analysis shows an unusual memory effect in which the remembered initial state property is not conserved in the integrable classical dynamics. We conclude with a discussion of relevant experiments and the potential generality of this mechanism for long time memory and the breakdown of thermalization.
Toward the Source of Thought: Insights from David Bohm on a Sustainable Future

This article explores insights of physicist David Bohm on the source of thought and the creative intelligence that emerges from this source. It highlights a link that Bohm sees between this creativ...
Sociodemographic Determinants of Life's Simple 7: Implications for Achieving Cardiovascular Health and Health Equity Goals.

Background: Life’s Simple 7 (LS7; nutri­tion, physical activity, cigarette use, body mass index, blood pressure, cholesterol, glucose) predicts cardiovascular health. The principal objective of our study was to define demographic and socioeconomic factors associated with LS7 to better inform programs addressing cardiovascular health and health equity. Methods: National Health and Nutrition Examination Surveys 1999–2016 data were analyzed on non-Hispanic White [NHW], NH Black [NHB], and Hispanic adults aged ≥20 years without cardiovascular disease. Each LS7 variable was assigned 0, 1, or 2 points for poor, intermediate, and ideal lev­els, respectively. Composite LS7 scores were grouped as poor (0–4 points), intermediate (5–9), and ideal (10–14). Results: 32,803 adults were included. Mean composite LS7 scores were below ideal across race/ethnicity groups. After adjusting for confounders, NHBs were less likely to have optimal LS7 scores than NHW (multivariable odds ratios (OR .44; 95% CI .37–.53), whereas Hispanics tended to have better scores (1.18; .96–1.44). Hispan­ics had more ideal LS7 scores than NHBs, although Hispanics had lower incomes and less education, which were independently associated with fewer ideal LS7 scores. Adults aged ≥45 years were less likely to have ideal LS7 scores (.11; .09–.12) than adults aged <45 years. Conclusions: NHBs were the least likely to have optimal scores, despite higher incomes and more education than Hispanics, con­sistent with structural racism and Hispanic paradox. Programs to optimize lifestyle should begin in childhood to mitigate pre­cipitous age-related declines in LS7 scores, especially in at-risk groups. Promoting higher education and reducing poverty are also important. Ethn Dis. 2020;30(4):637- 650; doi:10.18865/ed.30.4.637
A Novel Approach for Embedding and Traversing Problems in Serious Games

This paper presents a novel approach for embedding and traversing problems in serious games. Given a set of concepts, problems built upon these concepts, and the complexities of the concepts, we propose an automatic mechanism that aids the game developers on which problems can be put on the same level and which problems must only be reachable when certain dependencies are met. The proposed network traversal algorithm allows the player/student to efficiently complete all the problems with increasing complexity at each step. The proposed approach is general purpose and has has been implemented in our quantum cryptography game, QuaSim.
Unfinished monumental projects and institutional crisis in the early pre-Columbian Andes

Abstract The focus of this article centers on monumental ceremonial buildings that were planned but either left partially constructed or were completed in a fashion that differed from their original design. Instead of using these buildings to study the formation of collectivities and the consolidation of authority, I rely on their unfinished or altered character to study the crisis of institutions and organizations. This article uses the case of the middle Nepena Valley (Peru) during the first millennium BCE to illustrate the wealth of information that can be obtained from this kind of archaeological remains if archaeologists are able to put them in historical context. Moreover, the studied case, from the transition between the demise of the Cupisnique/Chavin religious complex and the warlike Salinar era, suggests the existence of a legitimation crisis derived from the contradiction between traditional forms of social integration and new priorities emerging within a climate of violence and conflict. Resumen: Este articulo se centra en edificios ceremoniales monumentales que fueron planeados, comenzados a ser construidos, pero que nunca fueron terminados, o al menos no como fueron originalmente planeados. En lugar de utilizar estos edificios para estudiar la formacion de colectividades o la consolidacion de autoridad, me baso en su caracter incompleto para estudiar la crisis de instituciones y organizaciones. Este articulo utilizar el caso del valle medio de Nepena (Peru) durante el primer milenio a.C. para ilustrar la riqueza de informacion que se puede obtener de esta clase de resto arqueologico si los arqueologos somos capaces de ubicarlos en su contexto historico. Mas aun, el caso estudiado, que trata de la transicion entre la caida del complejo religioso Cupisnique/Chavin y la era violenta de Salinar, sugiere la existencia de una crisis de legitimidad derivado de la contradiccion entre formas tradicionales de integracion social y las nuevas prioridades emergiendo de un clima de violencia y conflicto.
Germline predisposition to hematopoietic malignancies.

Once thought to be exceedingly rare, the advent of next-generation sequencing has revealed a plethora of germline predisposition disorders that confer risk for haematopoietic malignancies (HMs). These syndromes are now recognized to be much more common than previously thought. The recognition of a germline susceptibility risk allele in an individual impacts the clinical management and health surveillance strategies in the index patient and relatives who share the causative DNA variant. Challenges to accurate clinical testing include a lack of familiarity in many health care providers, the requirement for DNA samples that reasonably approximate the germline state, and a lack of standardization among diagnostic platforms as to which genes are sequenced and their capabilities in detecting the full range of variant types that confer risk. Current knowledge gaps include a comprehensive understanding of all predisposition genes; whether scenarios exist in which an allogeneic stem cell transplant using donor haematopoietic stem cells with deleterious variants is permissive; and effective means of delivering genetic counseling and results disclosure for these conditions. We are hopeful that comprehensive germline genetic testing, universal germline testing for all patients with an HM, universal germline testing for allogeneic haematopoietic stem cell donors, and the development of preventive strategies to delay or even prevent malignancies will be available in the near future. These factors will likely contribute to improved health outcomes for at-risk individuals and their family members.
Projekt abgebrochen, Folgeband nicht erschienen. Unvollendete Werke in der Wissenschaftsgeschichte der Geschichtswissenschaft

Die Konkurrenz zwischen Wissenschaftstheorie (Historik) und Wissenschaftsgeschichte der Geschichtswissenschaft scheint heute zugunsten der Wissenschaftsgeschichte entschieden. Dort herrscht allerdings zumindest in Deutschland noch der individualbiografische Ansatz vor. Wie innovativ dennoch auch dieser Zugriff sein kann, belegt die einschlagige jungste Monografie von Heinz Duchhardt. Sie befasst sich mit den inneren und auseren Ursachen nicht zustande gekommener oder abgebrochener Geschichtswerke und dem psychisch-ethischen Umgang der verantwortlichen Historiker mit ihrem „Versagen“. Das Review Essay stellt diese Perspektive kritisch in den ubergreifenden wissenschaftshistorischen Kontext und macht weiterfuhrende Forschungsvorschlage.
Impact of adjuvant therapies following surgery for anal melanoma.

Abstract Background Anal melanoma is rare. Surgery is standard of care for non-metastatic disease. There are limited data supporting adjuvant therapy. We sought to examine the impact of adjuvant radiation, chemotherapy and immunotherapy on survival. Methods The National Cancer Database was queried. Factors associated with overall survival were examined by Kaplan-Meier and Cox proportional hazards analyses. Patients were grouped by treatment regimen. Results 450 patients had complete treatment data: surgery alone (63.8%), surgery + radiation (14.9%), surgery + chemotherapy (7.6%), surgery + immunotherapy (9.6%) and non-surgical treatment (4.2%). Median survival was 27.2 months. Node-positive patients had worse survival than node-negative (22.4 vs. 36.8 months; p = 0.0002). Non-surgical treatment yielded worse survival than any surgery-inclusive regimen (10.4 vs. 27.8 months; p = 0.0002). No adjuvant modality conferred a survival advantage. By multivariate analysis, increasing age (HR/1 year = 1.02, p = 0.012) and node positivity (HR = 2.10, p = 0.0002) negatively impacted survival. Conclusion Adjuvant therapy for non-metastatic anal melanoma does not appear to influence survival.
Essays on Technology Adoption, Demographics, and Development

OF THE DISSERTATION Essays on Technology Adoption, Demographics, and Development by Ting-Wei Lai Doctor of Philosophy in Economics Washington University in St. Louis, 2015 Professor Ping Wang, Chair Professor B. Ravikumar, Co-Chair This dissertation is to connect empirical findings with grounded theoretical analysis on two economic issues. One of the studies investigates industrial productivity by fitting in a theoretical model with quantitative methods. In addition, I explore how a demographic policy in China brings forth a profound impact in all aspects of the fast-growing economy. The first chapter, “Casual Labor, Uncertainty, and Technology Adoption in Agriculture,” examines why both the technology adoption rate and labor productivity in agriculture are low in the context of developing countries. A two-stage model is built to explain how the availability of casual (non-permanent) labor ex-post, in the presence of uncertainty may affect agents’ ex-ante technology choices. A higher degree of uncertainty induces the agents to choose traditional production technology that relies heavily on the labor input instead of using any modern intermediate inputs. By calibrating the model to fit the micro data in Tanzania, I show that this proposed framework can be used to account for two targets of interest: low aggregate labor productivity and the low technology adoption rate. Counterfactual exercises suggest that the severity of uncertainty before the harvest stage and the abundance of casual labor are the potential drivers for the two targets to be explained.
Pruning a sufficient dimension reduction with a p-value guided hard-thresholding

Principal fitted component (PFC) models are a class of likelihood-based inverse regression methods that yield a so-called sufficient reduction of the random p-vector of predictors X given the response Y. Assuming that a large number of the predictors has no information about Y, we aimed to obtain an estimate of the sufficient reduction that ‘purges’ these irrelevant predictors, and thus, select the most useful ones. We devised a procedure using observed significance values from the univariate fittings to yield a sparse PFC, a purged estimate of the sufficient reduction. The performance of the method is compared to that of penalized forward linear regression models for variable selection in high-dimensional settings.
Advances in distributed sensor technology

Advances in Distributed Sensor Technology by S.S. Iyengar, L. Prasad, and Hla Min 273 pp. $68 Prentice Hall Upper Saddle River, N.J. 1995 ISBN 0-13-360033-5
Alcohol Reverses Religion's Prosocial Influence on Aggression

The relationship between religion and violence is controversial. Discrepant findings exist between survey studies and the limited number of experimental investigations of religiosity's influence on aggressive behavior. We have attempted to resolve this discrepancy by addressing previous limitations in the literature and assessing a heretofore-untested moderator of religiosity and aggression: alcohol intoxication. This investigation included a community sample of 251 men and 269 women randomly assigned to either an acute alcohol intoxication condition or a placebo condition. Participants completed a series of questions drawn from standardized instruments of religiosity and spirituality prior to competing on an aggression laboratory paradigm in which electric shocks were received from, and administered to, a fictitious opponent under the guise of a competitive reaction-time task. Hierarchical regression analyses revealed a significant beverage-by-religiosity interaction. Religiosity predicted lower levels of aggression for participants in the placebo group and higher levels of aggression for intoxicated participants. Results indicated that high religiosity coupled with alcohol intoxication may be a risk factor for aggression. This novel finding may help to clarify previous discrepancies in studies of religiosity and aggression.
Streptococcus mutans biofilm formation: utilization of a gtfB promoter-green fluorescent protein (PgtfB::gfp) construct to monitor development

The glucosyltransferases of Streptococcus mutans are recognized as important virulence factors for this cariogenic bacterium. To study the expression of the gtfB gene of S. mutans in biofilms, a gtfB promoter (PgtfB)-green fluorescent protein (GFP) reporter system was developed. A Streptococcus-Escherichia coli shuttle vector harbouring a PGTFB::gfp cassette was introduced into S. mutans GS-5, and the expression of GFP by the transformed S. mutans cells was confirmed by fluorescence microscopy. Furthermore, confocal laser scanning microscopy was carried out on biofilms attached to polystyrene plates; enhanced gtfB expression was observed in various microcolonies across these biofilms. To further test the hypothesis that gtfB expression is upregulated in biofilms, flow cytometry analysis was done on planktonic and biofilm cells; this analysis showed an approximately five-fold increase in gtfB expression in the biofilm cells relative to the planktonic cells. Real-time (TaqMan) PCR analysis confirmed that gtfB expression in the biofilm cells was enhanced relative to the planktonic cells. Previously, it has been suggested that the S. mutans gtfC gene might be co-transcribed with gtfB. Therefore, RT-PCR analysis was performed on gtfB-expressing S. mutans; this analysis demonstrated that gtfC was co-transcribed with gtfB. These results indicated that GFP expression can be utilized to examine gene regulation in S. mutans biofilm formation.