cssi/SciSciGPT-SciSciNet huggingface dataset:
MRI Evaluation of cooperative and non-cooperative patients with non-traumatic acute abdominal pain - preliminary observations.

Abstract Purpose To compare diagnostic performance of two MRI protocols, motion resistant and conventional breath-hold, in patients with acute abdominal pain. Materials and methods Thirty-five patients unable to breath-hold underwent a motion-resistant protocol (Radial group). Twenty-seven patients able to breath-hold underwent conventional protocol. The diagnostic performance of MRI was calculated. Cartesian and radial 3D-GRE sequences were compared. Results In Radial group, diagnosis was correct in 31/35 patients (88.5%), with sensitivity and specificity of 85.7% and 87.5%. In Cartesian group, diagnosis was correct in 24/27 patients (88.9%), with sensitivity and specificity of 93.7% and 81.8%. Conclusion MRI appeared moderately successful for non-cooperative patients presenting with acute abdominal pain, with comparable accuracy to the standard breath-hold protocol.
Stress relaxation insensitive designs for metal compliant mechanism threshold accelerometers

Abstract We present two designs for metal compliant mechanisms for use as threshold accelerometers which require zero external power. Both designs rely on long, thin flexures positioned orthogonally to a flat body. The first design involves cutting or stamping a thin spring-steel sheet and then bending elements to form the necessary thin flexors. The second design uses precut spring-steel flexure elements mounted into a mold which is then filled with molten tin to form a bimetallic device. Accelerations necessary to switch the devices between bistable states were measured using a centrifuge. Both designs showed very little variation in threshold acceleration due to stress relaxation over a period of several weeks. Relatively large variations in threshold acceleration were observed for devices of the same design, most likely due to variations in the angle of the flexor elements relative to the main body of the devices.
Nebulizer Choice Affects the Airway Targeting of Amphotericin B Lipid Complex Aerosols

Background: Although amphotericin B is highly effective against fungal infections, it has serious adverse effects. Encapsulation of amphotericin B in liposomes reduces its potential for systemic side effects. Administration of liposomal amphotericin via aerosols to the lungs (a main portal of fungal infections) further reduces its toxicity while increasing its therapeutic index and prophylactic efficacy. However, the effectiveness of aerosol therapy depends on the dose deposited and the distribution of the drug within the lungs. The size of the aerosol particle is an important factor that affects the distribution of the drug within the lungs and the effectiveness of therapy. Objective: This study aims to determine the physicochemical suitability of amphotericin B lipid complex (ABLC) for aerosolization and to compare the performance of 3 commercially available air jet nebulizers in generating ABLC aerosols in terms of aerosol output (mg/min) and drug amount aerosolized within various particle-size ranges,...
Antigens recognized by autologous antibodies of patients with soft tissue sarcoma

Serological analysis of recombinant cDNA libraries (SEREX) uses high titer IgGs to identify antigens expressed by autologous cancers. In order to identify tumor antigens in soft tissue sarcoma (STS), sera from four patients with malignant fibrous histiocytoma (MFH), gastrointestinal stromal tumor (GIST), pleomorphic liposarcoma, and dedifferentiated liposarcoma were screened against cDNA libraries derived from autologous tumor. We identified 18 antigens encoded by 15 different genes, including DLG7, which is located on chromosome 14q22, a locus previously found to be altered in STS, and the proto-oncogene JUN. Ten of fourteen antigens (71%) do not react with sera from healthy donors, suggesting that antibody recognition takes place during cancer progression. Using oligonucleotide microarray technology, most genes were variably expressed across a panel of 16 benign specimens and 41 STSs of different histologies. DLG7, however, showed restricted expression in testes and cancer, similarly to known germ cell cancer-testis antigens (or germ cell antigens, GCAs). Thus, the current study identified several antigens, including molecules implicated in tumorigenesis that were recognized by high titer IgGs in STS patients. Further studies of these selected novel STS antigens are warranted to identify and characterize potential antigen targets expressed by STS.
Progress on Response of Rice Flower Organs and Rice Quality to Heat Stress

Since high temperature stress does serious harm on rice,it is of significant importance to carry out studies on heat tolerance in rice.This paper reviews the impact of heat stress on flower organs and yield traits of rice,the response of rice quality to high temperature stress,then proposes future research directions,so as to provide some references for the heat tolerance research in rice.
Investigation on an Outbreak of Diarrhea Caused by Norovious in Middle School Attached to Hunan Normal University in 2007

Objective To investigate the cause,process and epidemiological characteristics of an infectious diarrhea outbreak triggered by Norovirus in the Middle School Attached to Hunan Normal University.Methods Field epidemiological investigation was conducted.By describing the symptoms of three different stages,spaces and people,as well as combining with the clinical conditions and laboratory detected results,the pathogenic factors were examined and explored through different control groups.Results There were only 8 persons in that school showed the symptoms before March 4th.After March 4th,totally 727 persons started having the symptoms of nausea,vomiting,diarrhea and others,with the attack rate of 14.44%.Retrospective study showed that contract history,food,water source and other exposure factors were significantly associated with illness outbreak.Conclusions The infective diarrhea outbreak was caused by Norovirus,and the trigger factors may be related to contact history,food and drinking water.
Adapting to user preference changes in interactive recommendation

Recommender systems have become essential tools in many application areas as they help alleviate information overload by tailoring their recommendations to users' personal preferences. Users' interests in items, however, may change over time depending on their current situation. Without considering the current circumstances of a user, recommendations may match the general preferences of the user, but they may have small utility for the user in his/her current situation. We focus on designing systems that interact with the user over a number of iterations and at each step receive feedback from the user in the form of a reward or utility value for the recommended items. The goal of the system is to maximize the sum of obtained utilities over each interaction session. We use a multi-armed bandit strategy to model this online learning problem and we propose techniques for detecting changes in user preferences. The recommendations are then generated based on the most recent preferences of a user. Our evaluation results indicate that our method can improve the existing bandit algorithms by considering the sudden variations in the user's feedback behavior.
Fast Cell Segmentation Using Scalable Sparse Manifold Learning and Affine Transform-Approximated Active Contour

Efficient and effective cell segmentation of neuroendocrine tumor (NET) in whole slide scanned images is a difficult task due to a large number of cells. The weak or misleading cell boundaries also present significant challenges. In this paper, we propose a fast, high throughput cell segmentation algorithm by combining top-down shape models and bottom-up image appearance information. A scalable sparse manifold learning method is proposed to model multiple subpopulations of different cell shape priors. Followed by a shape clustering on the manifold, a novel affine transform-approximated active contour model is derived to deform contours without solving a large amount of computationally-expensive Euler-Lagrange equations, and thus dramatically reduces the computational time. To the best of our knowledge, this is the first report of a high throughput cell segmentation algorithm for whole slide scanned pathology specimens using manifold learning to accelerate active contour models. The proposed approach is tested using 12 NET images, and the comparative experiments with the state of the arts demonstrate its superior performance in terms of both efficiency and effectiveness.
Tricks of the Trade: Insights on Evaluation

Many educators believe that activities centered on electronic tangibles (ET) and robots are fun and motivating for their students. However, it is often difficult, given the nature of both new hardware and new curricula to tease apart the nature and causes of this excitement. Formally planned educational evaluations can help build a deeper understanding of the effects of the new program on students. However, evaluating the impact of new ETs can be a challenge. Classes and workshops utilizing ETs as teaching devices are by their nature hands-on and may not lend themselves to traditional exam-based assessments. After all of the effort required to design a new ET, plan an educational experience utilizing the technology, and then implement that plan with students, evaluation is sometimes left as an afterthought. Strong evaluation methods can provide important insights into ways to improve a design and help to show the impact of a program, resulting in increased opportunities for funding, dissemination, and replication.
Developmental regulation of membrane protein sorting in Drosophila embryos

We have examined the process of membrane protein targeting in the polarized cells of the developing Drosophila melanogaster embryo. Human placental alkaline phosphatase (PLAP) is a glycosylphosphatidyl inositol-linked protein that accumulates at the apical membranes of mammalian epithelial cells. A chimeric construct composed of the transmembrane and cytosolic portions of the vesicular stomatitis virus G protein coupled to the ectodomain of PLAP, termed PLAPG, has been found to behave as a basolateral protein (D. A. Brown, B. Crise, and J. K. Rose. Science Wash. DC 232: 34-47, 1989). The subcellular distributions of these proteins were examined in the epithelial and neuronal tissues of transgenic Drosophila embryos. In the surface ectoderm, both PLAP and PLAPG were restricted to the basolateral membranes throughout development. Internal epithelia derived from the surface ectoderm accumulated PLAP at their apical surfaces, whereas PLAPG retained its basolateral distribution. The redistribution of PLAP from the basolateral to the apical plasma membrane was found to be coincident with the invagination of the surface epithelium to form internal structures, suggesting that the sorting pathways that function in the epithelium of the Drosophila embryo are developmentally regulated.
Utilization of diagnostic ultrasound and intravenous lipid-encapsulated perfluorocarbons in non-invasive targeted cardiovascular therapeutics

Diagnostic ultrasound (DUS) pressures have the ability to induce inertial cavitation (IC) of systemically administered microbubbles; this bioeffect has many diagnostic and therapeutic implications in cardiovascular care. Diagnostically, commercially available lipid-encapsulated perfluorocarbons (LEP) can be utilized to improve endocardial and vascular border delineation as well as assess myocardial perfusion. Therapeutically, the liquid jets induced by IC can alter endothelial function and dissolve thrombi within the immediate vicinity of the cavitating microbubbles. The cavitating LEP can also result in the localized release of any bound therapeutic substance at the site of insonation. DUS-induced IC has been tested in pre-clinical studies to determine what effect it has on acute vascular and microvascular thrombosis as well as nitric oxide (NO) release. These pre-clinical studies have consistently shown that DUS-induced IC of LEP is effective in restoring coronary vascular and microvascular flow in acute ST segment elevation myocardial infarction (STEMI), with microvascular flow improving even if upstream large vessel flow has not been achieved. The initial clinical trials examining the efficacy of short pulse duration DUS high mechanical index impulses in patients with STEMI are underway, and preliminary studies have suggested that earlier epicardial vessel recanalization can be achieved prior to arriving in the cardiac catheterization laboratory. DUS high mechanical index impulses have also been effective in pre-clinical studies for targeting DNA delivery that has restored islet cell function in type I diabetes and restored vascular flow in the extremities downstream from a peripheral vascular occlusion. Improvements in this technique will come from three dimensional arrays for therapeutic applications, more automated delivery techniques that can be applied in the field, and use of submicron-sized acoustically activated LEP droplets that may better permeate the clot prior to DUS activation and cavitation. This article will focus on these newer developments for DUS therapeutic applications.
The Charter Schools of the Future—Possible Designs

This chapter continues the use of the Jungian framework to analyze some of the other important stakeholders that bear on TEM. Specifically, it looks at the properties and roles of teachers and teachers’ unions. The chapter shows that both teachers and unions are not equally developed in all of the Jungian quadrants. This lack of equal development significantly affects our ability as a society to lower the achievement gap between upper, middle class and poorer children.
Trends in Hospital Inpatient Admissions Following Early Medicaid Expansion in California

The Affordable Care Act is expected to profoundly affect inpatient hospital utilization, both as a result of expansions in insurance coverage as well as payment and delivery system reforms. The objective of this study is to examine changes in inpatient utilization between 2010 and 2013 in California, following a Medicaid expansion and implementation of the Delivery System Reform Incentive Payment program. Findings show that between 2010 and 2013: (a) the overall number of inpatient admissions increased, mainly because an increase in Medicaid admissions exceeded the decrease in uninsured admissions; (b) the number of preventable admissions did not change; (c) preventable admissions decreased at safety net hospitals that received Delivery System Reform Incentive Payment funds relative to other safety net hospitals. The results suggest that delivery system reforms may help offset the upward pressures on utilization and costs due to coverage expansions.
Red Ginseng as an Ergogenic Aid: A Systematic Review of Clinical Trials.

Purpose This systematic review was performed to summarize clinical trials assessing the effect of Red Ginseng (RG) supplementation on exercise performance and fatigue recovery. Methods Two English databases (PUBMED, MEDLINE) and two Korean databases (KISS, RISS) were used as systematic searching engines. We included only articles written in the English and Korean languages. Clinical trials, which evaluated exercise performance and recovery variables with RG supplementation, were included in this review. The methodological quality of all studies was assessed using the Cochrane Risk of Bias tool. Analysis was conducted with Comprehensive Meta-Analysis Version 3. Results In total, 135 potentially relevant studies were identified, and 14 studies were included. Overall, the aerobic capacity (VO2max, heart rate, time to exhaustion, shuttle run, and anaerobic threshold) exhibited no improvement with RG supplementation. In anaerobic capacity (peak power, mean power, and 30 m dash run), no significant improvements with RG supplementation was described in most of the studies. The antioxidant function predominantly measured by levels of superoxide dismutase (SOD) and malondialdehyde (MDA) showed mixed results. Red Ginseng's effects on fatigue recovery were evaluated using lactate as a main outcome. Two studies observed significant effects while other 5 studies showed no significant effects. Conclusion The clinical effects of RG have been assessed in various conditions. Although the number of studies presented in this review is small and results of studies are mixed, it is hypothesized that this review article may provide useful guideline to design and conduct future studies investigating efficacy of RG supplementation on exercise performance and fatigue recovery in human trials.
Seekers, Finders, Settlers, and Stumblers: Identifying the Career Paths of Males in the Genetic Counseling Profession.

Genetic counseling is a female-dominated profession, with 96% of counselors self-identifying as female. Research suggests gender diversification benefits healthcare professionals and the populations they serve. Therefore, this study explored how men choose a genetic counseling career, associations between career satisfaction and their career entry dynamics and experience levels, and differences due to experience level in how they decide on this profession. Twenty-five novice, experienced, or seasoned male counselors and 8 male genetic counseling students participated in semi-structured phone interviews. Interpretive content and cross-case analyses of interview data were informed by Simpson’s “Seekers, Finders, and Settlers” theory describing career entry dynamics of men in non-traditional (i.e., female-dominated) fields. Results revealed 13 interviewees were Seekers, who initially knew they wanted a career in genetic counseling, actively chose the profession, and were satisfied with their decision. Eleven were Settlers, who had tried different, traditional jobs, with limited satisfaction before actively finding and choosing genetic counseling. Two were Finders, who discovered genetic counseling while in the career decision making process and made a passive choice to pursue it as they had no feasible, satisfactory alternative. Seven men fit a new category, we termed “Stumblers,” who were in another career and satisfied, but changed to genetic counseling after happening to hear about it. Prevalent themes pertaining to participants’ experiences in the career include desire for a multidisciplinary career; lack of a priori knowledge of genetic counselor roles; late exposure to the profession; and varied perceptions of being in a non-traditional career. There were few differences due to experience level and career satisfaction was high across the sample. Results suggest earlier exposure to the career and availability of detailed descriptions of its multidisciplinary nature may increase the number of males in the profession.
Critiques of school psychological materials: Cognitive-behavioral therapy goes to school

Clinical assessment of personality is both an art -and a science. Where empirically based data are available, actuarial procedures are possible in predicting behavior or describing personality. But frequently the clinician’s art is called upon to bridge the gap or make an educated guess where data specific to the particular situation are lacking. Generally, this arrangement has served fairly well. Certainly all test score-behavior relationships have not been examined empirically for all populations, and likely they never will be. Apparently not all such relationships need to be tested, since well-trained professionals have been reasonably successful in going beyond available data and making adequate predictions in specific situations. But more science is needed in some areas. One of the significant areas where art or clinical judgment have been required to go far out on a limb with very little statistical support is in the use of the Minnesota Multiphasic Personality Inventory (MMPI) with adolescents. Few research studies have been conducted to test the applicability of the enormous MMPI adult data base to a younger population. Yet application is commonly made. The MMPI is probably the most widely used objective measure in clinical work with adolescents (Archer, 1987). In working with adolescents, clinicians often rely heavily on their impressions or judgment in interpreting MMPI profiles. The clinician may simply evaluate the adolescent profile as if it were an adult profile, or convert the raw scores to adolescentnormed T scores before interpreting the profile in terms of behavioral correlates obtained with adult subjects. The assumption that is implicit here is that no meaningful differences exist between adult and adolescent responses to the inventory’s items. Another procedure, perhaps too frequently applied, has been the modification of the interpretation of some scales because they are suspected of being influenced by age or the nature of the adolescent: “Scales 4 and 9 are high, but adolescents are usually high on them. So we can ignore their usual interpretation.” While many talented psychologists have been successful in applying their clinical art to the interpretation of adolescent MMPI profiles, the need for more science seems obvious here. Among the specific questions raised by a consideration of the validity of using the MMPI in adolescent personality assessment are the following: 1. Are adolescent MMPI scores best expressed in T scores based on adult or adolescent norms? Both are commonly used, yet they differ significantly particularly on scales F, 4, and 8. 2. Under what conditions can the MMPI be used successfully with younger subjects? While developed on an adult population, the MMPI has been used frequently
Measurements of the effective atomic numbers of minerals using bremsstrahlung produced by low-energy electrons

Abstract The accuracy of a method for measuring the effective atomic numbers of minerals using bremsstrahlung intensities has been investigated. The method is independent of detector-efficiency and maximum accelerating voltage. In order to test the method, experiments were performed which involved low-energy electrons incident on thick malachite, pyrite, and galena targets. The resultant thick-target bremsstrahlung was compared to bremsstrahlung produced using a standard target, and experimental effective atomic numbers were calculated using data from a previous study (in which the Z-dependence of thick-target bremsstrahlung was studied). Comparisons of the results to theoretical values suggest that the method has potential for implementation in energy-dispersive X-ray spectroscopy systems.
$X$ -band DC–DC Power Converter for High-Speed Bit-Stream Modulation

This letter proposes an X-band power converter for high-speed bit-stream modulation. The converter consists of a power amplifier (PA) with pulsed load modulation, which performs highly efficient dc–ac conversion for a wide range of output powers, and a switching rectifier. Power conversion was performed in the X-band, and the potential for broad bandwidth and profile minimization was demonstrated. The PA was fabricated using a discrete gallium-nitride HEMT device and it delivered 39-dBm RF output power with 57.4% drain efficiency (DE) at 9.2 GHz under class-B conditions. At 6-dB output power back-off, 38.2% DE was measured for a 4 Gb/s data rate. The switching rectifier is designed using a class-B PA strategy to demonstrate the proposed concept. The ac–dc conversion efficiency was measured to be 44.6%, and 3.05-W dc power was delivered.
Helical pulse-forming transmission line stack for compact pulsed power applications — Design and simulation

Design considerations and initial static charge and transient discharge simulations using COMSOL Multiphysics™ are presented for pulse-forming transmission (T-) line modules designed to be stacked, charged in parallel, and discharged in series. Each module is designed to use a rigid injection-molded dielectric cast in halves to accommodate the center conductor, and with a helical discharge path of constant real impedance Z. High peak energy density U 0 for high initial charge voltage V 0 is possible with such materials made of ceramic or ceramic powder-polymer composite. The helical path permits a high volume utilization efficiency η (effective system mean energy density/U 0 ) for compact applications. Given the system's cylindrical return conductor housing of outer radius R and height H, TV 0 2 = 4πR2HηU 0 Z for an impedance-matched load. Here, T is the time interval for which the load current and voltage are within the ranges for which the load is effectively driven (neglecting rise and fall times). The model is fully parameterized so, for example, each module's rectangular cross-section T-line aspect ratio A T (width/height) and helical aspect ratio A H (T-line center to helical axis distance/T-line half-width) are free to be varied. This allows for a wide range of system configurations to be studied with minimal effort. Given an optimized T-line inner conductor shape, the contribution to η from the T-line itself is about 1/3 for the A T = 1 — 4 range studied. The minimum A H considered is 2, giving an T-line volume fraction upper bound of 8/9 relative to the minimum cylindrical volume containing it. Their product implies an upper bound on η of about 0.3 Other system requirements, such as extra length and possibly higher AH needed to accommodate a low-inductance multi-channel spark-gap switch between modules and a spark-gap trigger circuit interior to the helix, respectively, and insulation for the erected voltage breakout and between the stages and return conductor, lower η further.
Structural Insights into IP3R Function

Inositol 1,4,5-trisphosphate receptors (IP3Rs) are ubiquitously expressed intracellular ligand-gated Ca2+ channels present on the endoplasmic reticulum of virtually all eukaryotic cells. These channels mediate the Ca2+ release from intracellular stores in response to activation by the signaling molecule IP3, which functions to transmit diverse signals received by the cell, e.g. from hormones, neurotransmitters, growth factors and hypertrophic stimuli, to various signaling pathways within the cell. Thus, IP3R channels can be conceptualized as highly dynamic scaffold membrane protein complexes, where binding of ligands can change the scaffold structure leading to cellular Ca2+ signals that direct markedly different cellular actions. Although extensively characterized in physiological and biochemical studies, the detailed mechanisms of how IP3Rs produce highly controlled Ca2+ signals in response to diversified extra- and intracellular stimuli remains unknown and requires high-resolution knowledge of channel molecular architecture. Recently, single-particle electron cryomicroscopy (cryo-EM) has yielded a long-awaited near-atomic resolution structure of the entire full-length type 1 IP3R. This structure provides important insights into the molecular underpinnings of ligand-mediated activation and regulation of IP3R. In this chapter, we evaluate available information and research progress on the structure of IP3R channel in an attempt to shed light on its function.
Collagen Metabolism in Wound Healing

A wound results in disruption of the normal continuity of body structures. Wound healing is restoration of the continuity of injured tissues. Collagen plays a crucial role in healing of wounds of skin and other tissues. There is general agreement that synthesis of collagen is required for restoration of physical strength of wounds. It is now also widely recognized that clarification of the precise role of collagen in the wound healing process requires not only information on the quantity of collagen present during the healing process, but, in addition, data on the rate at which collagen is synthesized, deposited and resorbed. Collagen biosynthesis includes unique biochemical processes, such as hydroxylation of proline to hydroxproline. Activity of these separate biosynthetic steps, likewise, must be evaluated for a thorough understanding of the function of collagen in wound healing. This review will emphasize collagen metabolism of cutaneous wounds not only because of the clinical and therapeutic significance of the healing of surgical incisions, but also since most experiments on collagen in wound healing have used skin injuries. The data to be summarized have been selected mainly from recent studies on “normal” wound healing. Unfortunately, few facts are available concerning collagen metabolism in healing complications such as keloids.
The Occurrence of Shear Bands in Metalworking

Shear bands, or regions of localized plastic flow crossing many grains, are not uncommon during the deformation processing of metals. They may occur under nominally isothermal conditions (tooling and workpiece at the same initial temperature) as well as non-isothermal conditions (tooling and workpiece at different temperatures). Under isothermal conditions, the localization of plastic flow is a function of the geometry involved in the metalworking operation, the deformation rate, and material properties such as the work-hardening or flow softening rate of the material and its strain rate sensitivity. For non-isothermal metalworking operations, these as well as other process and material parameters controlling temperature, and hence flow stress and strain, gradients must be considered to predict the occurrence of shear bands. Methods of predicting the occurrence and severity of shear bands are presented. The power of the analytical tools are demonstrated with results from studies of the hot forging behavior of several titanium alloys. Other observations of flow localization in a hot-work tool steel, a uranium alloy, and a superalloy are used to illustrate the generality of the concepts presented. In addition, shear band phenomena in metalcutting operations are reviewed in the context of the metalworking studies.
Customer oriented enterprise information management

Retention of existing customers is a priority for businesses to survive and prosper in the present marketplace. The extreme high cost of acquisition of new customers in a mature market has pushed organizations into actively seeking to build and sustain long-term relationships with customers. Such relationships are expected to be strong enough to provide substantial barrier to switching business over to competition except in the most extreme of cases. There are cognitive, affective and behavioral aspects of such relationships that are relevant. The transition of a neutral or negative relationship into positive territory is based on changes in one or more of these dimensions. Information exchanges between an organization and its customers play a significant role in such a change. The nature and scope of relationship with a customer changes, as the customer needs evolve in course of the product life cycle in the customer’s industry. A framework merging the concepts of “customer relationship management” and “product life cycle” into “customer relationship life cycle” is proposed.
Jews, Strangers and Foreigners

‘Jews, Strangers and Foreigners’ explores the second set of rumour mills, those that shaped the responses of the Romanian authorities to the crisis and as such it is an exploration of Romanian officials’ obsession with foreigners. Representatives of both the Conservative and Liberal governments, instead of confronting the actual economic, social and cultural causes of the uprising, preferred to ‘export’ the blame and pin it onto the handy construct of ‘the foreigner’. The chapter offers an analysis of the scapegoated Jewish community, of official fears regarding potential Russian and Bulgarian threats as well as the peasants’ animosity against ‘foreigners’. The misguided official responses to the agrarian crisis were instrumental in allowing the peasants’ simmering discontent to get out of hand.
The Effect of Alliances on Nuclear Proliferation

This paper lays out a theory of how alliances condition the odds of nuclear proliferation by a great-power's protege. A security guarantee extended by a great-power may deter proliferation by taking away the protege's willingness or opportunity to acquire nuclear weapons. When the protege is strong vis-a-vis its adversaries, its great-power sponsor will only be able to deter proliferation by using a "carrots approach" (i.e., reinforcing its commitment to the security of the protege) to remove its willingness to acquire nuclear weapons. When a protege is weak vis-a-vis its adversaries, its great-power sponsor may be able to deter proliferation by using a "sticks approach" (i.e., making its commitment to the security of the protege conditional on the maintenance of its non-nuclear status) to remove its opportunity to nuclearize. Both these approaches are more likely to succeed in deterring the protege's nuclear acquisition when its security goals are limited to its own survival or, being broader, risk entrapping the sponsor in a war over a goal it does not share with the protege. Proliferation by a great-power protege, therefore, is more likely when the sponsor is either not deeply committed to its survival or does not fear that the nuclearization of its protege will heighten its own risk of entrapment. We show the plausibility of this theory by laying out short case studies of the Israeli, South Korean, Taiwanese, and West German nuclear programs and conclude with implications for U.S. counter-proliferation policy.
Embodied Legal Education: Incorporating Another Part of Bloom's Taxonomy

Frequently overlooked in legal education is the psychomotor domain of Bloom’s taxonomy. The learning objectives in this domain concern the learning of the body, physical education in the broadest sense of the term. In legal education, psychomotor learning objectives can help law students learn how their bodies support their mental work, how their bodies communicate, and how other people’s bodies are communicating to them. This article explores the reasons why law professors should consider including in their lesson plans some learning objectives within the psychomotor domain and how they might do so.
STUDIES ON THERMAL METHODS OF MEASURING THE HOLDING TIME IN HIGH-TEMPERATURE SHORT-TIME PASTEURIZERS

Data are presented on the properties of thermal waves produced by several means of suddenly increasing or decreasing the temperature of the fluid moving through the holding tube of a high-temperatu...
CD28 costimulates macrophage suppression via increased IFNg production (100.21)

The high macrophage to T cell ratio (Mf:T) characteristic of the tumor microenvironment can be modeled using peritoneal cavity (PerC) cell culture. C57BL/6J PerC Mfs suppress T cell activation by IFNg-triggered expression of iNOS and IDO, enzymes that consume Arg and Trp. Attempts to reverse suppression by CD28 costimulation actually increased suppression and ELISPOT analyses revealed this was due to increased numbers of IFNg-secreting cells (gSC). Comparative analyses showed that C57BL/6 mice had more gSC than B-1 B cell deficient, BALB.xid mice and that these strains both had more gSC than BALB/c mice even though the latter had the greatest increase in gSC following costimulation. Titration experiments revealed that increased PerC cell density reduced the need for costimulation and increased gSC number. Both CD80 and CD86 knockout (KO) mice had fewer gSC than wildtype mice with CD80 KOs having fewer than CD86 KOs. These data reveal a “braking” role for IFNg in T cell responses and suggest that, rather than promote T cell activation, CD28-mediated costimulation could foster suppression of cell-mediated immunity via increased formation of Mf-T cell synapses within tumor microenvironments. Supported by NIH AREA R15- CA136901-01.
Non-decimated Quaternion Wavelet Spectral Tools with Applications

Quaternion wavelets are redundant wavelet transforms generalizing complex-valued non-decimated wavelet transforms. In this paper we propose a matrix-formulation for non-decimated quaternion wavelet transforms and define spectral tools for use in machine learning tasks. Since quaternionic algebra is an extension of complex algebra, quaternion wavelets bring redundancy in the components that proves beneficial in wavelet based tasks. Specifically, the wavelet coefficients in the decomposition are quaternion-valued numbers that define the modulus and three phases. The novelty of this paper is definition of non-decimated quaternion wavelet spectra based on the modulus and phase-dependent statistics as low-dimensional summaries for 1-D signals or 2-D images. A structural redundancy in non-decimated wavelets and a componential redundancy in quaternion wavelets are linked to extract more informative features. In particular, we suggest an improved way of classifying signals and images based on their scaling indices in terms of spectral slopes and information contained in the three quaternionic phases. We show that performance of the proposed method significantly improves when compared to the standard versions of wavelets including the complex-valued wavelets. To illustrate performance of the proposed spectral tools we provide two examples of application on real-data problems: classification of sounds using scaling in high-frequency recordings over time and monitoring of steel rolling process using the fractality of captured digitized images. The proposed tools are compared with the counterparts based on standard wavelet transforms.
Invasive Fungal Disease in the Transplant Population: An Overview

There are numerous fungal pathogens which merit consideration in the hematopoietic cell and solid organ transplant recipients including yeasts, filamentous molds, and endemic fungi. Important differences in the incidence, types, and timeline of infections exist among the differing transplant groups. The overall risk of invasive fungal infection is affected by a multitude of factors including the transplant donor and recipient as well as transplant type. These considerations guide the implementation of prophylactic strategies and assist in targeting those at highest risk of fungal disease.
Breaking the chain: GPO changes and hospital supply cost efficiency

Abstract The use of group purchasing organizations (GPOs) as a supply chain intermediary is a long-standing and strategic approach to enhancing supply cost efficiency in U.S. hospitals. As a consequence, a hospital's decision to reconfigure its GPO network can have critical ramifications for the hospital's supply cost performance. In this study, we conceptualize possible GPO changes as structural and relational and investigate the impact of GPO changes on supply cost efficiency. To this end, we employ archival, panel data from multiple sources that track the performance of 2,391 U.S. hospitals between 2009 and 2014. Our findings indicate that, whereas hospitals that make a structural GPO change experience a decrease in supply cost efficiency, hospitals that enact a relational change are shown to experience improvements in supply cost efficiency. Our findings have important theoretical and managerial implications for supply chain management and hospital administrators.
Medical Device Security in the IoT Age

Medical devices save lives, but as wireless technology continues its exponential growth, these devices often utilize these technologies to connect to the hospital network. As a result of this connectedness, networks face numerous security vulnerabilities due to security issues with the devices and software used to process the medical information and operate the device. Additionally, medical devices often fall outside the scope of normal IT discovery scans, and there are numerous issues with these IP connected devices because they lack updated software patching. As a result, vulnerabilities to the hospital network are magnified by the inability to not only locate the devices, but also, if the device is captured on the network, issues arise with patching and the ability to load updates to software with respect to the Food and Drug Administration (FDA) Regulations. Antiquated procedures and lack of a security focus on the part of medical device manufacturers has created tremendous risk that needs to be balanced between potentially life-saving technologies and security for patients on multiple levels. The analysis of this paper will focus on the issues inherent with the current process of discovery, the updating and patching of vulnerable software processes, manufacturer responsibilities, and potential interim solutions for healthcare providers that can help identify risks as we wait for changes to the current FDA processes and provide steps that healthcare providers can take in the interim to protect their networks.
Current treatment of metastatic endometrial cancer

Background: Endometrial cancer is the most common gynecologic malignancy. The majority of patients have disease confined to the uterus and have an excellent overall prognosis. However, subgroups of patients have advanced primary disease or recurrences following primary treatment. Methods: The management of metastatic disease is variable, depending on factors such as comorbidities, tumor grade, performance status, and prior treatments. Management options include hormonal therapy and cytotoxic chemotherapy, as well as targeted therapies that inhibit angiogenesis and the cellular signaling pathways involved in cell growth and proliferation. A comprehensive review of these treatments for metastatic endometrial cancer was conducted and is discussed. Results: Hormonal therapy and cytotoxic chemotherapy have traditionally been used in the treatment of metastatic endometrial cancer. Advances in molecular biology have led to multiple potential targeted therapies to be used in the treatment of metastatic endometrial cancer. Conclusions: While several treatment modalities are now available to treat patients who present with metastatic endometrial cancer, overall prognosis remains poor. Systemic treatments for patients with metastatic endometrial cancer are reviewed.
Cost-Effectiveness of a School-Based Chlamydia Screening Program, Duval County, FL.

During the 2015-2016 school year, the Florida Department of Health in Duval County hosted Teen Health Centers (TeenHC) at five high schools of Jacksonville providing HIV/STD screening and pregnancy testing. The purpose of this study was to assess the cost-effectiveness of the TeenHC chlamydia screening program and determine at what student participation level, the program can be cost-effective. We assessed the costs and effectiveness of the chlamydia screening program compared with "no TeenHC". Cost-effectiveness was measured as cost per quality-adjusted life years (QALY) gained. At a program cost of US$61,001 and 3% participation rate, the cost/QALY gained was $124,328 in the base-case analysis and $81,014-$264,271 in 95% of the simulation trials, all greater than the frequently citied $50,000/QALY benchmark. The cost/QALY gained could be 7%. The TeenHC chlamydia screening has the potential to be cost-effective. Future program efforts should focus on improving student participation.
Symptomatic Hemorrhage From Cerebral Cavernous Malformations: Evidence from a Cohort Study.

Objective Patients with a cerebral cavernous malformation (CCM) can have intracranial hemorrhages ranging from insignificant and chronic microbleeds to life-threatening hemorrhage. Management decisions and patient counseling are based on a heterogeneous body of evidence. We sought to improve the literature by providing our results based on the standardized definitions and aimed to delineate differences in the symptomatic burden for CCMs, based on their anatomic location and presence of developmental venous anomalies. This evidence will aid in clinical decision making and patient counseling. Methods A retrospective cohort analysis between 1990 and 2018 was performed, including patients with a diagnosis of a CCM. The primary outcome was acute symptomatic hemorrhages. Results We identified 438 patients harboring 632 CCMs. Mean age at diagnosis was 50 years (standard deviation ±17 years). Median follow-up was 26 months (interquartile range, 7–72 hours). Multiple lesions were encountered in 64 patients (15%). An initial symptomatic presentation was observed in 64% of the patients. There were 438 supratentorial lesions (69%) and 194 infratentorial lesions (31%). A symptomatic hemorrhage was observed in 25% of the supratentorial lesions and 29% of the infratentorial lesions (P Conclusions Infratentorial cavernous malformations are more likely to present with symptomatic hemorrhages at diagnosis or during follow-up when accounting for size differences between lesions.
Anti-EGFR Fibronectin Bispecific Chemically Self-Assembling Nanorings (CSANs) Induce Potent T cell Mediated Anti-Tumor Response and Downregulation of EGFR Signaling and PD-1/PD-L1 Expression

Numerous approaches have targeted the Epidermal Growth Factor Receptor (EGFR) for the development of anti-cancer therapeutics, since it is over-expressed on a variety of cancers. Recently, anti-EGFR chimeric antigen receptor (CAR)-T cells have shown potential promise for the immunological control of tumors. Our laboratory has recently demonstrated that bispecific chemically self-assembled nanorings (CSANs) can modify T cell surfaces and function as prosthetic antigen receptors (PARs). This technology allows selective targeting of tumor antigens due to high avidity of the multimeric rings, while incorporating a mechanism to dissociate the rings to prevent further T cell stimulation. Previously, PARs with single- chain variable fragments (scFvs) have been successful in vitro and in vivo, activating T cells selectively at the tumor site. Alternatively, here we report fibronectin (FN3)-based PARs with improved properties such as increased protein yield, rapid protein production, increased protein stability and predicted low immunogenicity due to the human origin of fibronectins. We examined the cytotoxicity of EGFR- targeting PARs in vitro in which the affinities of the anti-EGFR fibronectins, the anti-EGFR/anti-CD3 valency of the CSANs and the antigen expression levels were varied. Based on these selective in vitro cytotoxicity results, we conducted an in vivo study of FN3-PARs using an orthotopic breast cancer model. The FN3- PARs demonstrated potent tumor growth suppression with no adverse effects. Furthermore, these results demonstrated that FN3-PARs modulated the tumor microenvironment by downregulating EGFR signaling resulting in decreased PD-L1 expression. In addition, the expression of PD-1 was also found to be reduced. Collectively, these results demonstrate that FN3-PARs have the potential to direct selective T cell targeted tumor killing and that anti-EGFR FN3-PARs may enhance anti-tumor T cell efficacy by modulating the tumor microenvironment.