cssi/SciSciGPT-SciSciNet huggingface dataset:
The Madden–Julian Oscillation and Its Impact on Northern Hemisphere Weather Predictability

Abstract The Madden–Julian oscillation (MJO) is known as the dominant mode of tropical intraseasonal variability and has an important role in the coupled-atmosphere system. This study uses numerical model experiments to investigate the influence of the MJO activity on weather predictability in the midlatitudes of the Northern Hemisphere. The National Aeronautics and Space Administration (NASA) Goddard Laboratory for the Atmospheres (GLA) general circulation model was used in a 10-yr simulation with fixed climatological SSTs to generate a control dataset as well as to select initial conditions for active MJO periods and “Null” cases. Two perturbation numerical experiments were performed for the 75 cases selected [(4 MJO phases + Null phase) × 15 initial conditions in each]. For each alternative initial condition, the model was integrated for 90 days. Mean anomaly correlations and standardized root-mean-square errors in the midlatitudes of the Northern Hemisphere (20°–60°N) were computed to assess predictab...
Emotional intelligence levels in baccalaureate-prepared early career registered nurses

Objective: The increasing complexity of the healthcare environment calls for increasing emotional intelligence (EI) competence in nurses. This study assessed the EI competence of 164 baccalaureate nursing alumni who graduated during the years 2007-2010 from three Benedictine institutions located in the Midwestern United States to see if there was growth of EI with experience as a registered nurse (RN), and to determine if age, gender, grade point average (GPA), and years of total healthcare work experience prior to graduation predicted EI. Methods: Participants completed the web-based Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) and a demographic survey. Results: Findings indicated 79.4% of participants were competent or higher on the MSCEIT total EI score. Percentages of nurses scoring in the competent or higher range on each of the four branch scores of perceiving, using, understanding and managing emotions were 80.6%, 72.7%, 84.2%, and 84.9% respectively. There were no significant differences on EI scores between graduates with 1-2 years compared to 3-5 years of experience as a RN. Results of a linear stepwise regression indicated being female was a significant predictor on the MSCEIT total EI score (P = 0.015) and using emotions branch (P = 0.047). Findings also indicated GPA (P < 0.001) and being female (P = 0.023) were significant predictors of EI on the understanding emotions branch. Conclusions: The findings indicate there is work to be done to improve the EI competence of nursing graduates. Continued research on the topic of EI and nursing is needed to build the knowledge base on how to promote positive patient outcomes.
Coronary angioscopy: Clinical applications

Percutaneous coronary angioscopy is an invaluable alternative imaging modality that can not be used routinely in the interventional cardiac catheterization laboratory. The major value of angioscopy lies in its ability to determine safely, quickly, and accurately intraluminal morphologies before and after coronary interventions. The results from angioscopy can then be used to target more specific treatment strategies, given the vast array of interventional treatment strategies available. Percutaneous coronary angioscopy, however, requires meticulous attention for the proper preparation and use of the angioscope to minimize the potential risks associated with the imaging procedure.
Redefining the Translational Status of 80S Monosomes

Fully assembled ribosomes exist in two populations: polysomes and monosomes. While the former has been studied extensively, to what extent translation occurs on monosomes and its importance for overall translational output remain controversial. Here, we used ribosome profiling to examine the translational status of 80S monosomes in Saccharomyces cerevisiae. We found that the vast majority of 80S monosomes are elongating, not initiating. Further, most mRNAs exhibit some degree of monosome occupancy, with monosomes predominating on nonsense-mediated decay (NMD) targets, upstream open reading frames (uORFs), canonical ORFs shorter than ∼ 590 nt, and ORFs for which the total time required to complete elongation is substantially shorter than that required for initiation. Importantly, mRNAs encoding low-abundance regulatory proteins tend to be enriched in the monosome fraction. Our data highlight the importance of monosomes for the translation of highly regulated mRNAs.
Managing Inventories: Determining Order Quantity

Cycle-stock ordering decisions, including cost-element considerations, are examined. As materials flow from suppliers through a firm's operations to customers, the cost-effectiveness of inventory investment is improved by the development and implementation of an inventory management system.
Sentry-based scheme: toward long-lived, robust wireless sensor networks

Wireless sensor network has been gaining ground in applications involving remote surveillance and date collection. However, there are still barriers to overcome to deploy these applications in large scale, one of which is the limited network lifetime. Extending network lifetime is challenging in that wireless sensor networks are built out of error-prone and short-lived wireless sensor nodes. In order to extend the network lifetime beyond an individual node’s lifetime, a common practice is to deploy a large array of sensor nodes, and have only a minimal set of nodes active performing duties while others stay in sleep mode to conserve energy. With this rationale, random node failures, either in active nodes or in redundant nodes, can seriously disrupt system operations. To address this issue, we proposed two node scheduling schemes to meet requirements from different applications: R-Sentry , a gang-based scheduling algorithm that attempts to bound the service loss time stemming from random node failures by coordinating the schedules among redundant nodes; and P-Sentry, a light-weight algorithm that keeps a certain number of redundant nodes always active while the others in deep sleep in an attempt to reduce the overhead caused by frequent wake-ups. Like any other network, wireless sensor network is also subject to attacks from adversaries. The fact that, in the course of the network lifetime, only a minimum number of sensor nodes are active in R-Sentry leaves the system more vulnerable to attacks from malicious nodes. In the second part of the dissertation, we present two variants of R-Sentry: Pre-emptive R-Sentry and Random Scheduling R-Sentry, to address scheduling-related attacks on R-Sentry.
The Making of Nigeria's Pharmaceutical Market

In the 1970s Nigeria’s oil boom propelled the country into unprecedented wealth, quite in contrast to a massive U.S. and indeed global economic recession at the time. During this period, U.S. and European multinational companies turned to Nigeria to manufacture drugs and sold them on what was then a significant and important foreign market in terms of sales. By the 1990s, proprietary drug markets in Nigeria and throughout Africa were completely eviscerated and relocated elsewhere. What was once almost exclusively a proprietary drug market is now home to mostly imported pharmaceuticals throughout the world, for which there are constant looming concerns over drug quality. This paper provides an overview of the historical convergences that made these drastically different kinds of markets possible: structural adjustment, speculative waves of industry consolidations, new sites of manufacturing outsourcing, and ever-increasing downward pricing pressures create arbitrage incentives for producing pharmaceuticals of infinite chemical variability and questionable quality. The paper also discusses the Nigerian government’s attempts to discern trans-continental drug trade. Pharmaceuticals of all chemical quality traverse through the country’s popular economy, which also constitutes its wholesale system, creating plenty of obstacles for regulation.
Quantum Mechanical Calculation of Noncovalent Interactions: A Large-Scale Evaluation of PMx, DFT, and SAPT Approaches.

Quantum mechanical (QM) calculations of noncovalent interactions are uniquely useful as tools to test and improve molecular mechanics force fields and to model the forces involved in biomolecular binding and folding. Because the more computationally tractable QM methods necessarily include approximations, which risk degrading accuracy, it is essential to evaluate such methods by comparison with high-level reference calculations. Here, we use the extensive Benchmark Energy and Geometry Database (BEGDB) of CCSD(T)/CBS reference results to evaluate the accuracy and speed of widely used QM methods for over 1200 chemically varied gas-phase dimers. In particular, we study the semiempirical PM6 and PM7 methods; density functional theory (DFT) approaches B3LYP, B97-D, M062X, and ωB97X-D; and symmetry-adapted perturbation theory (SAPT) approach. For the PM6 and DFT methods, we also examine the effects of post hoc corrections for hydrogen bonding (PM6-DH+, PM6-DH2), halogen atoms (PM6-DH2X), and dispersion (DFT-D3 ...
Notes on Boletes—I 1. the Generic Position of Boletus Subglabripes and Boletus Chromapes 2. a Comparison of Four Species of Tylopilus

A study of Boletus subglabripes and Boletus chromapes in relation to the diagnostic characters of the genus Leccinum failed to substantiate the transfer of either species to Leccinum. Boletus chrom...
Serum cholesterol, phospholipid and lipoprotein levels in elderly male subjects.

SummaryThe cholesterol, phospholipid and Sf 12-20 levels in the blood serum were determined in a number of elderly subjects all over the age of 52. In these age groups there was a slight decrease in Sf level with age and a good correlation between the Sf level and the cholesterol level. The phospholipid level was found to vary linearly with the cholesterol level.
Changes in temporal attention inhibition following prolonged exposure and sertraline in the treatment of PTSD.

Objective Attentional inhibitory deficits expressed as difficulty ignoring irrelevant stimuli in the pursuit of goal-directed behavior may serve as a fundamental mechanism of posttraumatic stress disorder (PTSD). Evidence of inhibitory processes as central to extinction suggests that exposure-based treatments may act more directly on the inhibitory deficits implicated in PTSD, whereas, in facilitating serotonergic neurotransmission, selective serotonin reuptake inhibitors (SSRIs) may be less direct and bring about general neurochemical changes in the fear circuitry. If these inhibitory deficits underlie PTSD, then inhibition should improve with successful treatment, with those treated with prolonged exposure (PE) potentially resulting in greater changes in inhibition than those treated with sertraline.
Study on Endocrine and Metabolic Characteristics in Obese Patients with Polycystic Ovary Syndrome under Different Obesity Standard

Objective:To explore the endocrine and metabolic characteristics in obese patients with polycystic ovary syndrome(PCOS) under different obesity standard so as to provide the basis for individualized diagnosis and treatment of PCOS.Methods:A total of 98 patients with PCOS,from January 2012 to January 2013,were recruited.With body mass index(BMI)≥24kg/m~2 as the obesity standard,72 cases were classified as obese A group,while the other 26 cases were classified as non-obese A group.With waist-hip ratio(WHR) ≥0.8 as the obesity standard,84 cases were classified as obese B group,while the other 14 cases were classified as non-obese B group.With BMI≥24 kg/m~2 and WHR≥0.8 as the obesity standard,64 cases were classified as obese C group,while 6 cases were classified as non-obese C group(BMI24 kg/m~2 and WHR0.8).The basic clinical data was recorded.The levels of basic serum hormones including follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),testosterone(T),and lipid metabolism-related indicators including triglycerides(TG),total cholesterol(TC),high-density lipoprotein(HDL-C),low-density lipoprotein(LDL-C) were measured.Fasting blood glucose(FBS),fasting insulin(FIN) were also measured.Results:The LH/FSH,FIN,HOMA-IR,TG levels in obese A group were higher than those in non-obese A group,and there was a decline trend in the age of menarche(P0.05).The FIN,HOMAIR,TG,LDL-C in obese B group were higher than those in non-obese B group,but the level of HDL-C in obese B group was lower than that in non-obese B group(P0.05).The FIN,HOMA-IR in obese C group were higher than those in non-obese C group,but the HDL-C level and the age of menarche in obese C group were lower than those in non-obese C group(P0.05).Multiple linear regression analysis showed that both WHR and BMI were associated with FBS.Conclusions:The endocrine and lipid metabolic levels in patients with PCOS are different under different obesity standards.Obesity may aggravate endocrine disorder and abnormal lipid metabolism so as to increase the risk of long-term complications.
Accounting for graduate medical education funding in family practice training.

BACKGROUND AND OBJECTIVES Medicare provides the majority of funding to support graduate medical education (GME). Following the flow of these funds from hospitals to training programs is an important step in accounting for GME funding. METHODS Using a national survey of 453 family practice residency programs and Medicare hospital cost reports, we assessed residency programs' knowledge of their federal GME funding and compared their responses with the actual amounts paid to the sponsoring hospitals by Medicare. RESULTS A total of 328 (72%) programs responded; 168 programs (51%) reported that they did not know how much federal GME funding they received. Programs that were the only residency in the hospital (61% versus 36%) and those that were community hospital-based programs (53% versus 22%) were more likely to know their GME allocation. Programs in hospitals with other residencies received less of their designated direct medical education payment than programs that were the only residency in the sponsoring hospital (-45% versus +19%). CONCLUSIONS More than half of family practice training programs do not know how much GME they receive. These findings call for improved accountability in the use of Medicare payments that are designated for medical education.
Management pitfalls in the use of embolization for the treatment of severe epistaxis.

Angiographic embolization for the treatment of severe recurrent epistaxis was added to the traditional treatment options—nasal packing, cauterization, and surgical vessel ligation—in 1974. Since th...
Differentiation in Business and Economics

The interpretation of published research involving differentiation is frequently complicated and impeded by the variety of definitions of the concept in use across disciplines. This paper examines differentiation from multiple perspectives offered in the economics and business literatures, with two objectives in view. A central objective is to delineate four main paradigms of differentiation, attending to their similarities and differences. The second is to identify linking concepts which tie the separate perspectives into an integrated network. The integrated perspective raises important questions regarding concept development, measurement and domain of application.
Usefulness of Atrial Fibrillation as a Marker for Adverse Cardiovascular Outcomes in Both Primary and Secondary Prevention in Patients With Implantable Cardioverter-Defibrillators

Whether the risk factors for cardiovascular (CV) outcomes are different in primary versus secondary prevention implantable cardioverter-defibrillator (ICD) patients is unclear. We sought to identify predictors of CV outcomes in ICD recipients for primary (G1) versus secondary prevention (G2). Consecutive patients who had ICD implanted during August 2005 to December 2009 were included. The primary outcome was a composite of appropriate shock, acute coronary syndrome, ischemic stroke, coronary revascularization, heart failure exacerbation, CV hospitalization, or all-cause death. We used Cox proportional hazards model and a stepwise selection method to fit the most parsimonious model to predict the primary outcome in all patients and separately for G1 and G2 patients. We followed 223 (184 G1 and 39 G2, mean age 61 years) patients through December 31, 2012; 141 (63.2%) developed the primary outcome. In all patients, atrial fibrillation (AF; hazard ratio 6.72, 95% CI 4.20 to 10.75; p
Education and peace go together; plus the best 2015 papers of the journal Temperature

As I am writing this editorial, the United States is preparing for the presidential election. I have no appetite to talk about this particular election, but I would like to share some of my thought...
Toxicology of BOPP in Large Animals

One of the most important characteristics of any therapeutic agent, including those for binary therapies such as BNCT and photodynamic therapy (PDT), is an acceptable level of toxicity The boronated porphyrin BOPP (Figure 1) is a “third generation” candidate for BNCT treatment of cerebral gliomas and potentially for other cancers. In pre-clinical studies in mice, BOPP has been shown to be selectively taken up in the C6 implanted intracerebral glioma after both intravenous and intraperitoneal administration.1 Doses as high as 200mg/kg were readily tolerated with no apparent signs of morbidity and no mortality of animals. Thus the maximum tolerated dose (MTD) in mice is at least this high. Tumor: normal brain ratios as high as 400:1 and tumor: blood ratios of 11:1 were readily obtainable with concomitant tumor BOPP levels of >200µg/g tumor equivalent to ~65ppm tumor boron. Since BOPP is a boronated free base porphyrin, it also is a potential sensitizer for photodynamic therapy (PDT). In rats bearing the C6 glioma, BOPP (25mg/kg iv) was found to be approximately one order of magnitude more effective than hematoporphyrin derivative (HpD) in producing the same degree of tumor necrosis depth while sparing normal brain.2 In contrast, BOPP seems to be more toxic in rats than would be predicted on the basis of the mouse MTD. Recent studies in rats bearing the 9L gliosarcoma suggest that the maximum tolerated dose in rats is only ~70mg/kg, a factor of approximately one-half what would be predicted on the basis of body surface area comparisons.3 Significant tumor growth delay following treatment with BOPP followed by thermal neutrons has been observed in mice bearing the KHJJ melanoma.4 Since larger animals are much more similar to humans than mice or rats, we undertook a full toxicological evaluation of BOPP in dogs.
Commentary: Is there any Influence of Variations in Context on Object-Affordance Effects in Schizophrenia? Perception of Property and Goals of Action.

In their recent article, Sevos et al. (2016) present data indicating that subjects with schizophrenia “have an impaired ability to experience an internal simulation of motor action potentialities when they perceived graspable objects” (p. 12). This lack of sensorimotor facilitation in patients with schizophrenia aligns broadly with other patient studies, and indicates that such individuals would require extensive use of higher cognitive processes even for the simplest routine activities in their daily life. A solid conclusion from this data would be certainly informative to understand the specific mechanisms behind schizophrenia.
How Does Shareholder Governance Affect the Cost of Borrowing

This paper examines the effect of internal corporate governance on creditors by implementing a regression discontinuity design. Using voting results on close-call shareholder-sponsored governance proposals, we compare the change in debt contract terms of firms with proposals passed to those with proposals failed. We find that banks demand higher loan spreads and more general covenants after the passage of proposals. The effects on loan terms are more pronounced for ex ante risky firms. Moreover, firms with proposals passed by a small margin become more volatile after the vote, indicating an increase in risk-shifting incentives of the firms. Collectively, our findings show that an increase in shareholder rights can exacerbate shareholder-debtholder conflicts and raise the cost of bank loans for firms.
Attitudes Toward Bisexual Men and Women

ABSTRACTTo better understand attitudes toward individuals who identify as bisexual, especially in how they compare to attitudes toward individuals identifying as gay and lesbian, students who self-identified as heterosexual completed an expanded version of Herek's (1994) revised Attitudes Toward Lesbians and Gay Men Scale. The expansion involved the inclusion of the identifiers bisexual men and bisexual women as part of a revision to Herek's scale. Results revealed attitudes that were more favorable toward lesbian and bisexual women than either gay or bisexual men. Further, attitudes toward bisexual men were significantly more negative than attitudes toward the other sexual orientation minorities. Implications for individuals who identify as bisexual and future research are discussed.
Very low concentrations of ethanol suppress excitatory synaptic transmission in rat visual cortex.

Ethanol is one of the most commonly used substances in the world. Behavioral effects of alcohol are well described, however, cellular mechanisms of its action are poorly understood. There is an apparent contradiction between measurable behavioral changes produced by low concentrations of ethanol, and lack of evidence of synaptic changes at these concentrations. Furthermore, effects of ethanol on synaptic transmission in the neocortex are poorly understood. Here, we set to determine effects of ethanol on excitatory synaptic transmission in the neocortex. We show that 1-50 mm ethanol suppresses excitatory synaptic transmission to layer 2/3 pyramidal neurons in rat visual cortex in a concentration-dependent manner. To the best of our knowledge, this is the first demonstration of the effects of very low concentrations of ethanol (from 1 mm) on synaptic transmission in the neocortex. We further show that a selective antagonist of A1 adenosine receptors, 8-cyclopentyl-1,3-dipropylxanthine (DPCPX), blocks effects of 1-10 mm ethanol on synaptic transmission. However, the reduction in excitatory postsynaptic potential amplitude by 50 mm ethanol was not affected by DPCPX. We propose that ethanol depresses excitatory synaptic transmission in the neocortex by at least two mechanisms, engaged at different concentrations: low concentrations of ethanol reduce synaptic transmission via A1 R-dependent mechanism and involve presynaptic changes, while higher concentrations activate additional, adenosine-independent mechanisms with predominantly postsynaptic action. Involvement of adenosine signaling in mediating effects of low concentrations of ethanol may have important implications for understanding alcohol's effects on brain function, and provide a mechanistic explanation to the interaction between alcohol and caffeine.
Transradial Approach for STEMI: From US Perspective

Despite a significant interest in transradial percutaneous coronary intervention (PCI) in the United States (US), transradial primary percutaneous coronary intervention (PPCI) lags behind. Femoral approach continues to be the preferred approach for PPCI among most US interventional cardiologists.
Tissue-engineered spiral nerve guidance conduit for peripheral nerve regeneration.

Abstract Recently in peripheral nerve regeneration, preclinical studies have shown that the use of nerve guidance conduits (NGCs) with multiple longitudinally channels and intra-luminal topography enhance the functional outcomes when bridging a nerve gap caused by traumatic injury. These features not only provide guidance cues for regenerating nerve, but also become the essential approaches for developing a novel NGC. In this study, a novel spiral NGC with aligned nanofibers and wrapped with an outer nanofibrous tube was first developed and investigated. Using the common rat sciatic 10-mm nerve defect model, the in vivo study showed that a novel spiral NGC (with and without inner nanofibers) increased the successful rate of nerve regeneration after 6 weeks recovery. Substantial improvements in nerve regeneration were achieved by combining the spiral NGC with inner nanofibers and outer nanofibrous tube, based on the results of walking track analysis, electrophysiology, nerve histological assessment, and gastrocnemius muscle measurement. This demonstrated that the novel spiral NGC with inner aligned nanofibers and wrapped with an outer nanofibrous tube provided a better environment for peripheral nerve regeneration than standard tubular NGCs. Results from this study will benefit for future NGC design to optimize tissue-engineering strategies for peripheral nerve regeneration. Statement of Significance We developed a novel spiral nerve guidance conduit (NGC) with coated aligned nanofibers. The spiral structure increases surface area by 4.5 fold relative to a tubular NGC. Furthermore, the aligned nanofibers was coated on the spiral walls, providing cues for guiding neurite extension. Finally, the outside of spiral NGC was wrapped with randomly nanofibers to enhance mechanical strength that can stabilize the spiral NGC. Our nerve histological data have shown that the spiral NGC had 50% more myelinated axons than a tubular structure for nerve regeneration across a 10 mm gap in a rat sciatic nerve. Results from this study can help further optimize tissue engineering strategies for peripheral nerve repair.
An Assistive Technology System that Provides Personalized Dressing Support for People Living with Dementia: Capability Study

Background: Individuals living with advancing stages of dementia (persons with dementia, PWDs) or other cognitive disorders do not have the luxury of remembering how to perform basic day-to-day activities, which in turn makes them increasingly dependent on the assistance of caregivers. Dressing is one of the most common and stressful activities provided by caregivers because of its complexity and privacy challenges posed during the process. Objective: In preparation for in-home trials with PWDs, the aim of this study was to develop and evaluate a prototype intelligent system, the DRESS prototype, to assess its ability to provide automated assistance with dressing that can afford independence and privacy to individual PWDs and potentially provide additional freedom to their caregivers (family members and professionals). Methods: This laboratory study evaluated the DRESS prototype’s capacity to detect dressing events. These events were engaged in by 11 healthy participants simulating common correct and incorrect dressing scenarios. The events ranged from donning a shirt and pants inside out or backwards to partial dressing—typical issues that challenge a PWD and their caregivers. Results: A set of expected detections for correct dressing was prepared via video analysis of all participants’ dressing behaviors. In the initial phases of donning either shirts or pants, the DRESS prototype missed only 4 out of 388 expected detections. The prototype’s ability to recognize other missing detections varied across conditions. There were also some unexpected detections such as detection of the inside of a shirt as it was being put on. Throughout the study, detection of dressing events was adversely affected by the relatively smaller effective size of the markers at greater distances. Although the DRESS prototype incorrectly identified 10 of 22 cases for shirts, the prototype preformed significantly better for pants, incorrectly identifying only 5 of 22 cases. Further analyses identified opportunities to improve the DRESS prototype’s reliability, including increasing the size of markers, minimizing garment folding or occlusions, and optimal positioning of participants with respect to the DRESS prototype. Conclusions: This study demonstrates the ability to detect clothing orientation and position and infer current state of dressing using a combination of sensors, intelligent software, and barcode tracking. With improvements identified by this study, the DRESS prototype has the potential to provide a viable option to provide automated dressing support to assist PWDs in maintaining their independence and privacy, while potentially providing their caregivers with the much-needed respite.
Association Between Work-Related Stress and Coronary Heart Disease: A Review of Prospective Studies Through the Job Strain, Effort-Reward Balance, and Organizational Justice Models.

Work‐related stress is an example of a psychosocial risk factor that has become of interest in today's ever‐demanding, fast‐paced, and globalized society, although its link to adverse health and in particular coronary heart disease (CHD) is incompletely understood. In this review, we will
Error Detection in Intensity-Modulated Radiation Therapy Quality Assurance Using Radiomic Analysis of Gamma Distributions

Purpose To improve the detection of errors in intensity-modulated radiation therapy (IMRT) with a novel method that uses quantitative image features from radiomics to analyze gamma distributions generated during patient specific quality assurance (QA). Methods and Materials One hundred eighty-six IMRT beams from 23 patient treatments were delivered to a phantom and measured with electronic portal imaging device dosimetry. The treatments spanned a range of anatomic sites; half were head and neck treatments, and the other half were drawn from treatments for lung and rectal cancers, sarcoma, and glioblastoma. Planar gamma distributions, or gamma images, were calculated for each beam using the measured dose and calculated doses from the 3-dimensional treatment planning system under various scenarios: a plan without errors and plans with either simulated random or systematic multileaf collimator mispositioning errors. The gamma images were randomly divided into 2 sets: a training set for model development and testing set for validation. Radiomic features were calculated for each gamma image. Error detection models were developed by training logistic regression models on these radiomic features. The models were applied to the testing set to quantify their predictive utility, determined by calculating the area under the curve (AUC) of the receiver operator characteristic curve, and were compared with traditional threshold-based gamma analysis. Results The AUC of the random multileaf collimator mispositioning model on the testing set was 0.761 compared with 0.512 for threshold-based gamma analysis. The AUC for the systematic mispositioning model was 0.717 versus 0.660 for threshold-based gamma analysis. Furthermore, the models could discriminate between the 2 types of errors simulated here, exhibiting AUCs of approximately 0.5 (equivalent to random guessing) when applied to the error they were not designed to detect. Conclusions The feasibility of error detection in patient-specific IMRT QA using radiomic analysis of QA images has been demonstrated. This methodology represents a substantial step forward for IMRT QA with improved sensitivity and specificity over current QA methods and the potential to distinguish between different types of errors.
Globalizing the Liberal Arts: Twenty-First-Century Education

Lewis argues that a liberal arts education will become increasingly important in the twenty-first century because the automation economy requires more than ever that individuals develop the cognitive flexibility and the habits of mind that allow for life-long learning. This article offers some historical context for the efforts of Yale and NUS to found a new liberal arts college in Asia. Lewis argues that liberal arts education attempts to shape students’ characters through engagement in a shared community shaped by conversations across various disciplines and points of view.
Globalization of Lifestyle: Golfing in China

Traditionally, a person’s lifestyle was more locally determined and evolved slowly. However, in the 21st century, globalization makes the globe flat, and lifestyle and taste are globally influenced and can change rapidly. This is especially true for the emerging new middle class, which has changed from primarily struggling for basic physiological needs to enjoying conspicuous consumption, thanks to more exposure to media and information. A good example is the emerging number of golfers in China. This paper uses recent, fast growing trends in golfing in China to illustrate how the tastes and preferences develop and are influenced by commercialization, globalization and public media and to show the impacts of golfing on the sustainable development. It is argued that golfing in China is a result of globalization and a desire to show off one’s status, prestige, wealth, delicacy and taste. The emerging middle class population provides the soil, but golf competitions, public media and globalization are the seeds and fertilizers. The impacts of golf courses on the environment and sustainability nationwide might not be very significant for the time being in China, but they have had some local impacts. This paper not only demonstrates the impact of globalization on lifestyle and sustainability, but also provides more general policy suggestions addressing similar problems and phenomena. It is suggested that not only regulation and taxes or economic incentives but also psychological and educational methods to change the public perception could be applied as well. At the societal level, consumer preferences and perception of “goodness” need to be redefined through education and public media.
Lymph node metastases in early gastric cancer, when the East and the West come to terms.

Endoscopic resection of early gastric cancer (EGC) is limited by the risk of lymph node metastasis (LNM). In general, resection of small (less than 2 cm) differentiated EGC which is limited to the mucosa is deemed safe due to negligible risk of lymph node metastasis. Expanding endoscopic resection beyond this criterion has been a matter of debate. In a land mark study by Gotoda et al., the risk of LNM for mucosal differentiated lesions without ulceration, irrespective of size, mucosal differentiated ulcerated lesions ≤2 cm, and poorly differentiated lesions ≤3 cm was 0% (1).
End-Stage Liver Disease and Indications for Liver Transplantation

Cirrhosis is a leading cause of morbidity and mortality in the United States. Once a patient develops complications from cirrhosis such as hepatic encephalopathy, ascites, esophageal variceal bleeding, or hepatocellular carcinoma, a liver transplantation should be considered. Patients with fulminant hepatic failure, systemic complications of liver disease, and liver-specific metabolic defects should also be considered for transplant. The evaluation for liver transplant is extensive and rigorous and involves numerous members from the transplant team to determine if transplantation is medically and psychosocially appropriate and technically feasible and is in the best interests of the patient.
Wildfire alters belowground and surface wood decomposition on two national forests in Montana, USA

Wildfires can drastically alter belowground processes such as organic matter (OM) decomposition. We used wood stakes of two different tree species, trembling aspen (Populus tremuloides Michx.) and loblolly pine (Pinus taeda L.), placed at three soil locations (soil surface, forest floor–mineral soil interface, mineral soil), as an index of the long-term (5-year) effects of wildfire on OM decomposition in two forest stands after high-severity wildfire and in an unburned control. Wood stake mass loss was generally higher for aspen, especially in the mineral soil of burned plots, than in control plots after 5 years. Soil surface and interface (unburned stands only) stakes showed few significant differences for either species on the Bitterroot National Forest. On the Gallatin National Forest, both pine and aspen stakes had significantly greater mass loss at the interface (unburned stand) at the end of 5 years, and also decayed significantly faster at the 10–20-cm depth in the wildfire area. Using wood stakes as an index of soil microsite properties in burned and unburned plots, we show that fire increased both OM decomposition and mineral soil microsite variability. These results strengthen our understanding of soil-surface and belowground ecosystem responses to wildfire.
Sparse Learning of Parsimonious Reproducing Kernel Hilbert Space Models

Reproducing kernel ilbert spaces (RKHSs) have been at the core of successful non-parametric tools in signal processing, statistics, and machine learning. Despite their success, the computational complexity of these models often hinders their use in practice. Indeed, fitting RKHS models typically relies on representer theorems to express the solution space as a combination of kernels evaluated at the training samples. Thus, the computational cost of evaluating these models is proportional to the number of training samples, which in many applications is prohibitively high. This issue is often addressed by sparsifying the coefficients of the kernel expansion, despite the fact that classical representer theorems no longer hold in the presence of sparsity penalties. In this work, we propose to directly tackle sparse learning over RKHSs by posing it as a functional problem. In other words, by formulating the RKHS model as a sparse, continuous combination of atoms from an overparametrized, continuous dictionary containing the value of the kernel evaluated at every point of the function domain. We show that despite the infinite dimensionality and non-convexity of the underlying optimization problem, these models can be fit exactly and efficiently using duality. We illustrate the performance of this technique in numerical experiments.
3D-printed guide for endodontic surgery

The purpose of this article is to illustrate the accuracy of a digitally planned 3D-printed guide for an apicoectomy procedure. A three-dimensional image was acquired of the patient’s teeth using cone beam computed tomography (CBCT). In utilizing open source software, an intraoral scan of the patient is combined with the CBCT image to design a surgical guide for an apicoectomy procedure. The surgical guide was 3D-printed and utilized for surgical apicoectomy accuracy.
Predictors of Negative Pressure Ventilation Response in Pediatric Acute Respiratory Failure

BACKGROUND: Use of negative-pressure ventilation is neither well described nor widespread in pediatric critical care; existing data are from small, specialized populations. We sought to describe a general population of critically ill subjects with acute respiratory failure supported with negative-pressure ventilation to find predictors of response or failure. METHODS: We conducted a retrospective cohort study of subjects 0–18 y old admitted to a single (non-cardiac) pediatric ICU who received acute respiratory failure support via negative-pressure ventilation from May 2015 through May 2016. RESULTS: In 118 subjects, the most common causes of acute respiratory failure were viral bronchiolitis (86.4%) and pneumonia (15.3%). A majority of subjects (68.6%) stabilized with negative-pressure ventilation and did not need a change of respiratory support; in those who failed with negative-pressure ventilation, median time to respiratory support change was 5.1 h (interquartile range 1.9–11.0). Subjects stabilized with negative-pressure ventilation did not differ from those needing a change of respiratory support in terms of age, comorbidities, or FIO2 at initiation of ventilation. Compared to those who did not respond to negative-pressure ventilation, mean SpO2/FIO2 was higher at 1 h after start of negative-pressure ventilation (218.8 vs 131.7) in those who did respond. Subjects with SpO2/FIO2 97% at 1 h after the start of negative-pressure ventilation. CONCLUSIONS: Negative-pressure ventilation successfully supported 69% of pediatric subjects with all-cause acute respiratory failure. Oxygen requirement was lower in subjects who were responsive to negative-pressure ventilation within 1 h of initiation. Standardized negative-pressure ventilation protocols should include weaning of supplemental oxygen to determine responsiveness.
On the Sidelines: Roles and Responsibilities of the Diamond Dolls in Intercollegiate Baseball

The purpose of this article is to examine the roles that women play in the Diamond Dolls organization and the meaning and significance of those (gendered) roles in the university and athletic setting. Specifically, I am concerned with the ways in which institutions construct and maintain hegemonic femininity (Choi, 2000; Krane, 2001). Employing a feminist approach, I critically explored the use of sexist language in the naming of a student organization, the roles and responsibilities of the Diamond Dolls, and the meaning of these roles within the context of intercollegiate sport. Lastly, the role that gender norms play in women’s participation in such organizations is also addressed.
Longitudinal Investigation of Older Adults' Ability to Self‐Manage Complex Drug Regimens

OBJECTIVES We sought to investigate older patients' ability to correctly and efficiently dose multidrug regimens over nearly a decade and to explore factors predicting declines in medication self-management. DESIGN Longitudinal cohort study funded by the National Institute on Aging. SETTING One academic internal medicine clinic and six community health centers. PARTICIPANTS Beginning in 2008, 900 English-speaking adults, aged 55 to 74 years, were enrolled in the study, completing a baseline (T1) assessment. To date, 303 participants have completed the same assessment 9 years postbaseline (T4). MEASUREMENTS At T1, subjects were given a standardized, seven-drug regimen and asked to demonstrate how they would take medicine over 24 hours. The number of dosing errors made and times per day that a participant would take medicine were recorded. Health literacy was measured via the Newest Vital Sign, and cognitive decline was measured by the Mini-Mental State Examination. RESULTS Participants on average made 2.9 dosing errors (SD = 2.5 dosing errors; range = 0-21 dosing errors) of 21 potential errors at T1 and 5.0 errors (SD = 2.1 errors; range = 1-18 errors; P < .001) at T4. In a multivariate model, limited literacy (β = .69; 95% confidence interval [CI] = .18-1.20; P = .01), meaningful cognitive decline (β = 1.72; 95% CI = .70-2.74; P = .01), number of chronic conditions (β = .21; 95% CI = .07-.34; P = .01), and number of baseline dosing errors (β = -.76; 95% CI = -.85 to -.67; P < .001) were significant, independent predictors of changes in dosing errors. Most patients overcomplicated their daily medication schedule; no sociodemographic characteristics were predictive of poor regimen organization in multivariate models. In a multivariate model, there were no significant predictors of changes in regimen consolidation over time, except regimen consolidation at T1. CONCLUSIONS Older patients frequently overcomplicated drug regimens and increasingly made more dosing errors over 9 years of follow-up. Patients with limited literacy, cognitive decline, and multimorbidity were at greatest risk for errors. J Am Geriatr Soc 68:569-575, 2020.
Sex Differences in the Association Between Frailty and Sarcopenia in Patients With Cirrhosis.

Author(s): Fozouni, Laila; Wang, Connie W; Lai, Jennifer C | Abstract: ObjectivesFrailty is prevalent in patients with cirrhosis and is hypothesized to result in part from sarcopenia, but the precise contribution of sarcopenia to frailty in this population is poorly understood.MethodsIncluded were patients with cirrhosis from 2011 to 2014 who had an ambulatory frailty assessment and abdominal computed tomography scan within 3 months. Logistic regression assessed the associations between frailty (=Liver Frailty Index ≥4.5), and sarcopenia (=skeletal muscle index of l39 cm/m for women and l50 cm/m for men).ResultsTwo hundred ninety-one participants were included: 33% were female. The median (interquartile range) Liver Frailty Index was 3.7 (3.3-4.2); 19% were frail. The median (interquartile range) skeletal muscle index was 49 cm/m (31-69); 36% had sarcopenia. Among the 54 frail participants, 48% had sarcopenia. In univariable logistic regression, sarcopenia was associated with a 1.86× increased odds of being frail (95% confidence interval [CI], 1.02-3.38). After adjusting for sex, etiology, hepatocellular carcinoma, MELDNa, ascites, encephalopathy, and hypertension, sarcopenia was associated with a 2.38× increased odds of being frail (95% CI, 1.17-4.85). After stratifying by sex and adjusting for MELDNa, sarcopenia among males was associated with a significantly increased odds of frailty (odds ratio 2.81, 95% CI, 1.19-6.67), whereas sarcopenia among females was not (odds ratio 1.38; 95% CI, 0.45-4.25).DiscussionIn patients with cirrhosis, sarcopenia was associated with a nearly 2-fold increased odds of being frail. Two-thirds of frail men displayed sarcopenia compared with only one-quarter of frail women. Contributors to the frail phenotype may differ by sex and support the need for sex-specific strategies to reduce frailty in this population.
Mechanisms of Nicotine Addiction

Tobacco smoking results in more than five million deaths each year and accounts for ∼90% of all deaths from lung cancer.3 Nicotine, the major reinforcing component of tobacco smoke, acts in the brain through the neuronal nicotinic acetylcholine receptors (nAChRs). The nAChRs are allosterically regulated, ligand-gated ion channels consisting of five membrane-spanning subunits. Twelve mammalian α subunits (α2-α10) and three β subunits (β2-β4) have been cloned. The predominant nAChR subtypes in mammalian brain are those containing α4 and β2 subunits (denoted as α4β2* nAChRs). The α4β2* nAChRs mediate many behaviors related to nicotine addiction and are the primary targets for currently approved smoking cessation agents. Considering the large number of nAChR subunits in the brain, it is likely that nAChRs containing subunits in addition to α4 and β2 also play a role in tobacco smoking. Indeed, genetic variation in the CHRNA5-CHRNA3-CHRNB4 gene cluster, encoding the α5, α3, and β4 nAChR subunits, respectively, has been shown to increase vulnerability to tobacco dependence and smoking-associated diseases including lung cancer. Moreover, mice, in which expression of α5 or β4 subunits has been genetically modified, have profoundly altered patterns of nicotine consumption. In addition to the reinforcing properties of nicotine, the effects of nicotine on appetite, attention, and mood are also thought to contribute to establishment and maintenance of the tobacco smoking habit. Here, we review recent insights into the behavioral actions of nicotine, and the nAChR subtypes involved, which likely contribute to the development of tobacco dependence in smokers.
Adapting 'Sunshine,' A Socially Assistive Chat Robot for Older Adults with Cognitive Impairment: A Pilot Study.

The COVID-19 pandemic challenges us to think outside of the box to respond to this unprecedented global crisis. In this letter, we propose a pilot study to use a socially assistive robot to help meet social needs for older adults with cognitive impairment residing in long-term care facilities.
Billroth 2 Gastroenterostomy

When the distal stomach needs to be resected, a reconstruction needs to be performed. Billroth described two different types of reconstructions. The present chapter discusses an end-to-side gastroenterostomy.
Bioenhanced "Virtues" May Threaten Personal Identity.

Fabiano (2021) argues that virtue theory offers the best “safety framework” for mitigating the risks of moral enhancement. He advances five desiderata for an ideal safety framework and then explain...