cssi/SciSciGPT-SciSciNet huggingface dataset:
Experience with the core curricular elements for international emergency medicine fellowships

The number of international emergency medicine (IEM) fellowships available in the US has grown dramatically since the inception of subspecialty training in 1994 Bayram et al. (Acad Emerg Med 17:748–757, 2010). These fellowships vary according to their curricular structure, intensity of fellow exposure and requirements for program completion. The variety of fellowship structures may have negative connotations for graduates from its fellowships and reflect upon the translatability of their skill sets. The recent article “Core Curricular Elements for International Emergency Medicine Fellowships” Alagappan and Holliman (Emerg Med Clin 23(1):1–10, 2005) was designed as a curricular development tool and enumerates seven foci within the broad field of IEM. The authors of this article describe their experience using this curriculum development tool. Individual experiences in each of the seven categories described in the “Core Curricular Elements” article were identified and undertaken within the typical 2-year training period. A curricular structure is described that integrates exposure to all seven areas along with the Master’s of Public Health (MPH) degree, the clinical component and the academic component thematic to existing fellowships. Benefits of this curriculum include increased exposure to multiple areas of IEM, potential for greater standardization and increased translatability of skill set. Disadvantages include superficial exposure to areas of IEM and potentially decreased travel time. The result is a plausible curriculum where fellows would gain exposure to more areas of IEM than they may have otherwise while still earning their MPH, working clinical shifts and carrying out academic fellowship requirements. The authors conclude that this structure allows fellowships to continue drawing on their strengths, provides a more well-rounded fellowship experience and increases structure without requiring standardization.
The use of RNAi-based screens to identify host proteins involved in viral replication

The recent development of RNAi-based techniques for protein knockdown in mammalian cells has allowed for unprecedented flexibility in the study of protein function. Currently, large siRNA libraries are available that allow the knockdown of all proteins known to be encoded by the human genome. These libraries have been used to identify the host proteins required for the replication of several clinically important viruses, including HIV, flaviviruses and influenza. This review summarizes the methods used in RNAi-based screening for host factors involved in virus replication, and discusses published examples of such screens.
Analytical modeling of a medium-voltage and high-frequency resonant coaxial-type power transformer for a solid state transformer application

This paper introduces a unique medium-voltage and high-frequency resonant coaxial-type power transformer (RCT) for a power-distribution level Solid State Transformer (SST) application [1]. The dc-dc stage of the SST application requires a compact high performance resonant transformer that operates under high electric stress and frequency. The RCT discussed in this work brings the virtues of the coaxial-type transformer, which has been use in radio frequency applications, to medium-voltage power conversion applications. The high frequency parasitic effects, which are negligible at 60Hz, become a significant concern in a SST operating above kHz range. Hence, the parasitics of the transformer need to be accurately predicted and controlled for quality power control and safety. The RCT not only minimizes the parasitics of the transformer but also integrates a resonant tank comprised of a series inductance and shunt capacitance by utilizing the stray magnetic and electric flux within the transformer. The limited space in compact size is efficiently used and materials can be optimized. The unique analytic design method of an RCT is introduced and the equivalent circuit model is developed in this paper. The specific design is based on the high performance transformer for a dual-active bridge (DAB) converter, which is one of the most popular topologies in bidirectional power conversion, in the dc-dc stage of the SST application being developed at the FREEDM System Center and its concept is verified with FEM analysis and experiments.
Sharing ontology schema information for Web service integration

In spite of many standards efforts, Web services with similar or compatible functionalities often have heterogeneous semantics. One reason is the disparate ontologies used for service descriptions. In order to compare and compose Web services, the ability to merge different ontologies is essential. This paper describes an approach to align numerous, independently designed ontologies. Our approach is a completely automated one, without the need for prior agreement on semantics. It incorporates WordNet and heuristic reasoning and infers new knowledge by self-learning. Our system provides a solid base for the seamless integration of Web services.
Cost Burden of Stroke Mimics and Transient Ischemic Attack after Intravenous Tissue Plasminogen Activator Treatment

Background Treatment decisions for patients with acute stroke symptoms are based on pertinent history, neurologic examination, laboratory studies, and head computed tomography. In this setting, patients with stroke mimic (SM) may mistakenly receive intravenous tissue plasminogen activator (IV-rtPA). The goal of this study was to investigate the excess direct/indirect hospital costs among patients who received IV-rtPA when final diagnosis was not ischemic stroke. Methods We reviewed the records of 535 IV-rtPA–treated patients who presented to our primary stroke centers. The diagnosis of SM or transient ischemic attack (TIA) was based on patient presentation, hospital course, electroencephalography, and negative neuroimaging studies. The excess cost analysis compared actual direct and indirect hospital costs of a patient to what their direct and indirect hospital costs would have been had they primarily been diagnosed with mimic or TIA. Results Seventy-four patients post–IV-rtPA treatment had final diagnosis of SM; 21 had TIAs. The excess direct and indirect hospital costs for mimics were $257,975 and $152,813, respectively. The median excess cost was $5401 per admission. The excess total cost for TIAs was $85,026 with a median of $3407 per admission. Conclusions Administration of IV-rtPA to patients with SMs remains prevalent and costly. Certain clinical or radiographic characteristics can help diagnose mimics; however, more studies need to be done to determine the feasibility and effectiveness of further clinical investigations among suspected SM patients who are within the thrombolysis treatment window.
Pathogenesis of haemophilic synovitis: clinical aspects.

Summary. Arthropathy remains a major cause of morbidity in patients with haemophilia. Frequent bleeding into the joints leads to joint damage with resultant contractures, joint deformities and arthritis. This in turn leads to muscle atrophy, limited physical activity, osteoporosis and disability. Even though several studies of prophylactic factor replacement for persons with severe haemophilia demonstrate improved joint function, this therapy is still not readily available to most people with haemophilia around the world and a universal treatment protocol has not been used. In this article, we discuss key issues in the treatment of severe haemophilia: the optimal timing of initiation and termination of therapy, dosing options and goals of therapy. The options for countries where prophylaxis is not readily available are also discussed. Most studies are small and not randomized making consensus treatment recommendations difficult to formulate. Randomized, clinical trials are needed to provide the answers regarding the optimal treatment of patients with severe haemophilia.
Monte Carlo and Phantom Study of the Radiation Dose to the Body from Dedicated CT of the Breast

Purpose: To prospectively determine the radiation dose absorbed by the organs and tissues of the body during a dedicated breast computed tomography (CT) study by using Monte Carlo methods and a phantom. Materials and Methods: By using the Geant4 Monte Carlo tool kit, the Cristy anthropomorphic phantom and the geometry of a dedicated breast CT prototype were simulated. The simulation was used to track x-rays emitted from the source until their complete absorption or exit from the simulation limits. The interactions of the x-rays with the 65 different volumes representing organs, bones, and other tissues of the phantom that resulted in energy deposition were recorded. These data were used to compute the radiation dose to the organs and tissues during a complete dedicated breast CT scan relative to the average glandular dose to the imaged breast (relative organ dose [ROD]), by using the x-ray spectra proposed for dedicated breast CT imaging. The effectiveness of a lead shield for reducing the dose to the org...
Detection of incipient stator winding faults in PMSMs with single-layer fractional slot concentrated windings

Abstract Permanent magnet synchronous machines designed with single-layer fractional slot concentrated windings are inherently fault tolerant; however, this does not eliminate the occurrence of winding failures. The ability to detect pending failures during operation provides added reliability. In this paper, an online fault detection technique is developed for high resistance inter-turn winding faults. It is shown through analysis, simulation and experiment that variations are present in the DC reference voltages prior to the presence of a short-circuit.
Relationship between changes in activity and plantar ulcer recurrence in a patient with diabetes mellitus

Background and Purpose. Although pressure-reducing interventions have been effective in the healing of neuropathic foot ulcers, these ulcers frequently recur in people with diabetes mellitus (DM). This case report illustrates how sudden changes in weight-bearing activity may have affected ulcer recurrence in a patient with DM and how the physical stress theory (PST) relates to ulcer recurrence for this patient. Case Description. The patient was a 66-year-old man with a history of DM, peripheral neuropathy, and recurrent plantar ulcers. His plantar ulcer healed after total contact casting. Outcome. Despite relatively low peak plantar pressure (9.3 N/cm2), the patient's ulcer recurred within 4 weeks of healing. Plantar pressure assessment and activity monitoring suggested that a rapid and sudden increase in weight-bearing activity (steps per day) contributed to cumulative plantar tissue stress that was 3.3 times higher on the day of ulcer recurrence than his average value. Although his cumulative plantar stress was high compared with his usual value, the cumulative value was similar to the amount of daily stress of individuals without a history of recurrent ulcers. Discussion. Within the context of the PST, rapid change in activity level may have an effect on cumulative stress and the risk of ulcer recurrence.
Premalignancy in Prostate Cancer: Rethinking What We Know

High-grade prostatic intraepithelial neoplasia (PIN) has been accepted as the main precursor lesion to invasive adenocarcinoma of the prostate, and this is likely to be the case. However, in an unknown number of cases, lesions fulfilling the diagnostic criteria for high-grade PIN may actually represent intra-acinar or intraductal spread of invasive carcinoma. Intriguingly, this possibility would not contradict many of the findings of previous epidemiologic studies linking high-grade PIN to carcinoma or molecular pathologic studies showing similar genomic (e.g., TMPRSS2-ERG gene fusion) as well as epigenomic and molecular phenotypic alterations between high-grade PIN and carcinoma. Also, this possibility would be consistent with previous anatomic studies in prostate specimens linking high-grade PIN and carcinoma in autopsy and other whole prostate specimens. In addition, if some cases meeting morphologic criteria for PIN actually represent intra-acinar spread of invasive carcinoma, this could be an important potential confounder of the interpretation of past clinical trials enrolling patients presumed to be without carcinoma, who are at high risk of invasive carcinoma. Thus, in order to reduce possible bias in future study/trial designs, novel molecular pathology approaches are needed to decipher when an apparent PIN lesion may be intra-acinar/intra-ductal spread of an invasive cancer and when it truly represents a precursor state. Similar approaches are needed for lesions known as intraductal carcinoma to facilitate better classification of them as true intra-ductal/acinar spread on one hand or as precursor high-grade PIN (cribriform type) on the other hand; a number of such molecular approaches (e.g., coevaluating TMPRSS-ERG fusion and PTEN loss) are already showing excellent promise. Cancer Prev Res; 9(8); 648-56. ©2016 AACR.
A review of the use of Avitene in otolaryngologic surgery.

Chairman's Comments: Control of hemorrhage is a problem familiar to all otolaryngologists, whether the bleeding occurs post-tonsillectomy, from spontaneous epistaxis, or from major head and neck su...
Orthogonal test on determination of trace lead in chicken by graphite furnace atomic absorption spectrometry

Objective:To develop an analytical method of trace lead in chicken by graphite furnace atomic absorption spectrometry using orthogonal test.Methods: After the chicken was cleared up with microwave,the lead in sample solution was determined by graphite furnace atomic absorption spectrometry using four factors(incineration temperature,incineration time,atomization temperature,atomization time) three level orthogonal test.Results: The test with incineration temperature 750℃,incineration time 25 s,atomization temperature 1500℃,atomization time 3 s is a better test condition.Conclusion: The times of orthogonal test are few than times of routine test.The method is suitable for the determination of trace lead in chicken by graphite furnace atomic absorption spectrometry.
An interpretation of transference.

This paper offers an interpretation of the concept of transference. It begins with a re-examination of Socrates's therapeutic intent and Plato's revisions of psychological theory in the light of Socrates's failure. In particular, Plato devised an account of a structured psyche, a theory of fantasy, and a complex 'object-relations' theory, to explain dynamic interactions between psyche and social world. It is argued that these revisions embody a recognition of the phenomenon of transference, i.e. the psyche's characteristic activity of creating a meaningful world in which to live. Freud's early conception of transference--as a transfer of psychological content across space and time--is criticised on the ground that it assumes that the world is already given, independent of any psychic activity. Freud's later conception of transference as a repetition is then explored in the light of the psyche's ability to create artefacts. It is argued that neurotic transference is the unconscious attempt to create an idosyncratic polis, an idiopolis, in which to live. The resolution of the transference occurs because the analyst is made a citizen of the idiopolis, has learned the idiolect, and can speak in that idiolect of the fundamental conflicts within the idiopolis and their dynamic basis. A neurotic world cannot survive this internal recognition.
An Ontological Approach to Engineering Requirement Representation and Analysis

Requirement planning is one of the most critical tasks in the product development process. Despite its significant impact on the outcomes of the design process, engineering requirement planning is often conducted in an ad hoc manner without much structure. In particular, the requirement planning phase suffers from a lack of quantifiable measures for evaluating the quality of the generated requirements and also a lack of structure and formality in representing engineering requirements. The main objective of this research is to develop a formal Web Ontology Language ontology for standard representation of engineering requirements. The proposed ontology uses explicit semantics that makes the ontology amenable to automated reasoning. To demonstrate how the proposed ontology can support requirement analysis and evaluation in engineering design, three possible services enabled by the ontology are introduced in this paper. These services are information content measurement, specificity and completeness analysis, and requirement classification. The proposed ontology and its associated algorithms and tools are validated experimentally in this work.
Synchrony and diachrony in Menominee derivational morphology

This paper identifies two difficulties with treatments of derivation in Algonquian languages. In traditional approaches to grammar, in which the morpheme is seen as a unitary entity, morphemes are understood as minimal units of meaning and/or function. Definitions share an appeal to the morpheme’s indivisibility. In the Algonquianist literature, in contrast, some morphemes (‘components’) can themselves contain other morphemes (which we call ‘formatives’) and they can also be synchronically derived from other components or stems. Drawing data from Menominee, we propose that these difficulties disappear if the formatives are seen as historical rather than synchronic units, while the components are the synchronic morphemes. Formatives bear the hallmarks of historical products of morphologization (phonetic/phonological reduction, semantic bleaching, and increase in grammatical function), and we conclude that they are not part of synchronic grammatical computation. This resolves problems present in traditional and modern theoretical approaches to Algonquian derivation, and has broader ramifications for linguistic theory: in both the structuralist and generativist traditions, synchronic grammar has often been seen as expansive, responsible for generating surface patterns that may instead be products of history. This has been the case in phonology and syntax. The present paper provides a study of the phenomenon in derivational morphology, and suggests that a more modest role for synchronic rules is called for.
Phosphate modified ceria as a Brønsted acidic/redox multifunctional catalyst

Deposition of trimethylphosphate onto ceria followed by thermal treatment resulted in the formation of surface phosphates with retention of the ceria fluorite structure. The structural and chemical properties of the phosphate-functionalized ceria were studied using 31P solid-state NMR, XPS, zeta titration, ammonia thermal desorption, pyridine adsorption, and model reactions. The introduction of phosphates generated Bronsted acid sites and decreased the number of Lewis acid sites on the surface. The relative amount of Lewis and Bronsted acids can be controlled by the amount of trimethylphosphate used in the synthesis. Upon deposition of Pd, the multifunctional material showed enhanced activity for the hydrogenolysis of eugenol and guaiacol compared to Pd on the unmodified ceria support. This was attributed to the cooperativity between the Lewis acid sites, which activate the substrate for dearomatization, and the redox/Bronsted acid properties, which catalyze hydrogenolysis.
The activity of cGMP-dependent protein kinase Iα is not directly regulated by oxidation-induced disulfide formation at cysteine 43.

Abstract The type I cGMP-dependent protein kinases (PKGs) are key regulators of smooth muscle tone, cardiac hypertrophy, and other physiological processes. The two isoforms PKGIα and PKGIβ are thought to have unique functions because of their tissue-specific expression, different cGMP affinities, and isoform-specific protein-protein interactions. Recently, a non-canonical pathway of PKGIα activation has been proposed, in which PKGIα is activated in a cGMP-independent fashion via oxidation of Cys43, resulting in disulfide formation within the PKGIα N-terminal dimerization domain. A “redox-dead” knock-in mouse containing a C43S mutation exhibits phenotypes consistent with decreased PKGIα signaling, but the detailed mechanism of oxidation-induced PKGIα activation is unknown. Therefore, we examined oxidation-induced activation of PKGIα, and in contrast to previous findings, we observed that disulfide formation at Cys43 does not directly activate PKGIα in vitro or in intact cells. In transfected cells, phosphorylation of Ras homolog gene family member A (RhoA) and vasodilator-stimulated phosphoprotein was increased in response to 8-CPT-cGMP treatment, but not when disulfide formation in PKGIα was induced by H2O2. Using purified enzymes, we found that the Cys43 oxidation had no effect on basal kinase activity or Km and Vmax values; however, PKGIα containing the C43S mutation was less responsive to cGMP-induced activation. This reduction in cGMP affinity may in part explain the PKGIα loss-of-function phenotype of the C43S knock-in mouse. In conclusion, disulfide formation at Cys43 does not directly activate PKGIα, and the C43S-mutant PKGIα has a higher Ka for cGMP. Our results highlight that mutant enzymes should be carefully biochemically characterized before making in vivo inferences.
Polytopic Connective Stability

Abstract The purpose of this paper is to consider connective stability of large scale systems when the interconnection matrices are allowed to move within a convex polytope. Distinct sets of sufficient vertex conditions are derived for polytopic connective stability in terms of convex M -matrices. A brief overview of the literature on the connective stability concept is provided, because of its relevance in stability analysis of hybrid systems.
Design principles from multiscale simulations to predict nanostructure in self-assembling ionic liquids

Molecular dynamics simulations (up to the nanoscale) were performed on the 3-methyl-1-pentylimidazolium ionic liquid cation paired with three anions; chloride, nitrate, and thiocyanate as aqueous mixtures, using the effective fragment potential (EFP) method, a computationally inexpensive way of modeling intermolecular interactions. The simulations provided insight (preferred geometries, radial distribution functions and theoretical proton NMR resonances) into the interactions within the ionic domain and are validated against 1H NMR spectroscopy and small- and wide-angle X-ray scattering experiments on 1-decyl-3-methylimidazolium. Ionic liquids containing thiocyanate typically resist gelation and form poorly ordered lamellar structures upon mixing with water. Conversely, chloride, a strongly coordinating anion, normally forms strong physical gels and produces well-ordered nanostructures adopting a variety of structural motifs over a very wide range of water compositions. Nitrate is intermediate in character, whereby upon dispersal in water it displays a range of viscosities and self-assembles into nanostructures with considerable variability in the fidelity of ordering and symmetry, as a function of water content in the binary mixtures. The observed changes in the macro and nanoscale characteristics were directly correlated to ionic domain structures and intermolecular interactions as theoretically predicted by the analysis of MD trajectories and calculated RDFs. Specifically, both chloride and nitrate are positioned in the plane of the cation. Anion to cation proximity is dependent on water content. Thiocyanate is more susceptible to water insertion into the second solvent shell. Experimental 1H NMR chemical shifts monitor the site-specific competition dependence with water content in the binary mixtures. Thiocyanate preferentially sits above and below the aromatic ring plane, a state disallowing interaction with the protons on the imidazolium ring.
Facile synthesis, structure, biocompatibility and antimicrobial property of gold nanoparticle composites from cellulose and keratin.

Abstract A novel, one-pot method was developed to synthesize gold nanoparticle composite from cellulose (CEL), wool keratin (KER) and chloroauric acid. Two ionic liquids, butylmethylimmidazolium chloride and ethylmethylimmidazolium bis(trifluoromethylsulfonyl)imide were used to dissolve CEL, KER and HAuCl 4 . X-ray diffraction and X-ray photoelectron results show that Au 3+ was completely reduced to Au 0 NPs with size of (5.5 ± 1) nm directly in the composite with NaBH 4 . Spectroscopy and imaging results indicate that CEL and KER remained chemically intact and were homogeneously distributed in the composites with Au 0 NPs. Encapsulating Au 0 NPs into [CEL+KER] composite made the composite fully biocompatible and their bactericidal capabilities were increased by the antibacterial activity of Au 0 NPs. Specifically, the [CEL+KER+Au 0 NPs] composite exhibited up to 97% and 98% reduction in growth of antibiotic resistant bacteria such as vancomycin resistant Enterococcus faecalis and methicillin resistant Staphylococcus aureus , and was not cytotoxic to human fibroblasts. While [CEL+KER] composite is known to possess some antibacterial activity, the enhanced antibacterial observed here was due solely to added Au 0 NPs. These results together with our previous finding that [CEL+KER] composites can be used for controlled delivery of drugs clearly indicate that the [CEL+KER+Au 0 NPs] composites possess all required properties for successful use as dressing to treat chronic ulcerous infected wounds.
Programmable Peptide-Cross-Linked Nucleic Acid Nanocapsules as a Modular Platform for Enzyme Specific Cargo Release

Herein we describe a modular assembly strategy for photo-cross-linking peptides into nucleic acid functionalized nanocapsules. The peptides embedded within the nanocapsules form discrete nanoscale populations capable of gating the release of molecular and nanoscale cargo using enzyme–substrate recognition as a triggered release mechanism. Using photocatalyzed thiol–yne chemistry, different peptide cross-linkers were effectively incorporated into the nanocapsules and screened against different proteases to test for degradation specificity both in vitro and in cell culture. By using a combination of fluorescence assays, confocal and TEM microscopy, the particles were shown to be highly specific for their enzyme targets, even between enzymes of similar protease classes. The rapid and modular nature of the assembly strategy has the potential to be applied to both intracellular and extracellular biosensing and drug delivery applications.
Extracellular Vesicles As Mediators of Cardiovascular Calcification

Involvement of cell-derived extracellular particles, coined as matrix vesicles (MVs), in biological bone formation was introduced by Bonucci and Anderson in mid-1960s. In 1983, Anderson et al. observed similar structures in atherosclerotic lesion calcification using electron microscopy. Recent studies employing new technologies and high- resolution microscopy have shown that although they exhibit characteristics similar to MVs, calcifying extracellular vesicles (EVs) in cardiovascular tissues are phenotypically distinct from their bone counterparts. EVs released from cells within cardiovascular tissues may contain either inhibitors of calcification in normal physiological conditions or promoters in pathological environments. Pathological conditions characterized by mineral imbalance (e.g., atherosclerosis, chronic kidney disease, diabetes) can cause smooth muscle cells, valvular interstitial cells, and macrophages to release calcifying EVs, which contain specific mineralization-promoting cargo. These EVs can arise from either direct budding of the cell plasma membrane or through the release of exosomes from multivesicular bodies. In contrast, MVs are germinated from specific sites on osteoblast, chondrocyte, or odontoblast membranes. Much like MVs, calcifying EVs in the fibrillar collagen extracellular matrix of cardiovascular tissues serve as calcification foci, but the mineral that forms appears different between the tissues. This review highlights recent studies on mechanisms of calcifying EV formation, release, and mineralization in cardiovascular calcification. Furthermore, we address the MV-EV relationship, and offer insight into therapeutic implications to consider for potential targets for each type of mineralization.
Improving Static SMS Spam Detection by Using New Content-based Features

As the use of mobile phones grows, spams are becoming increasingly common in mobile communication such as SMS, calling for the research on SMS spam detection. Most of the existing detection techniques for SMS spams are have been mostly adapted from other contexts such as emails and the web but ignored some unique characteristics of SMS in spam detection. Moreover, spammers are constantly developing more sophisticated tactics, rendering previous features and methods for spam detecting no longer effective. In this paper, we propose to incorporate different new content based features to improve the performance of SMS spam detection. The effectiveness of the proposed features is empirically validated using multiple classification methods. The results demonstrate that the proposed features can improve the performance of SMS spam detection.
A Game Theoretic Model for Determining When Baseball Arbitration Creates the Proper Incentives for Litigants

This paper creates a game theoretic model to determine how pendulum arbitration or baseball arbitration impacts the incentives of litigants. Pendulum arbitration is when both parties submit competing proposals and the arbitrator chooses only one of the bids, in its entirety, to be binding on both parties. Pendulum arbitration is most famous for its use in salary disputes between baseball players and their team when both parties can’t agree on contract terms. Many believe that pendulum arbitration incentivizes both parties to submit more “conservative” bids and, thus, creates the proper incentives for parties in a dispute. Our game theoretic model explains that this is not always the case. Whether or not pendulum arbitration will create the proper incentives for litigants is largely based on other factors such as the arbitrator’s error rate and the ability of the litigants to “lever up.” Using this model we are able to explain the success of pendulum arbitration in labor disputes and baseball. We can also use our model to explain why pendulum arbitration would not work in corporate valuation situations. Finally, we use our model to propose a few disputes such as marital asset distribution and consumer/business disputes which, according to our model, would be ideal for pendulum arbitration.
Refocusing knowledge generation, application, and education: raising our gaze to promote health across boundaries.

Those educating healthcare professionals face the undeniable challenge that the current U.S. healthcare system is untenable.1 U.S. health care epitomizes low value—spending more than any other country while ranked 37th in the world—between Costa Rica and Slovenia, in its ability to equitably engender health.2 The September 14–15, 2010 conference on Patients and Populations: Public Health in Medical Education, sponsored by the Association of American Medical Colleges (AAMC) and the CDC, provided inspiring examples from those who are trying to show the healthcare professionals of the future a better way. Yet, with U.S. healthcare spending American business into noncompetitiveness,3 mortgaging not only our children’s but our grandchildren’s futures, the task is more than to bring a public health understanding into the mainstream of research and medical education.4–6 The urgent need is to inspire and enable the younger generation to spring over the current dysfunctional medico-industrial complex, to bubble up diverse new streams that together create a torrential delta of change, so that quality health care becomes about both health and caring, accessible to all, while still leaving resources to strengthen the social and environmental determinants of health.5 This daunting task—providing high-value health care for all while spending less and doing more to improve the actual health of the population—requires a different way of understanding health care and health than the current biomedical model. It requires a more inclusive way of framing the generation of new knowledge and of applying that knowledge in education and practice. This reframing involves raising the gaze and spanning boundaries.
Development, commissioning, and evaluation of a new intensity modulated minibeam proton therapy system.

PURPOSE To invent, design, construct, and commission an intensity modulated minibeam proton therapy system (IMMPT) without the need for physical collimation and to compare its resulting conformity to a conventional IMPT system. METHODS A proton therapy system (Hitachi, Ltd, Hitachi City, Japan; Model: Probeat-V) was specially modified to produce scanned minibeams without collimation. We performed integral depth dose acquisitions and calibrations using a large diameter parallel-plate ionization chamber in a scanning water phantom (PTW, Freiburg, Germany; Models: Bragg Peak ionization chamber, MP3-P). Spot size and shape was measured using radiochromic film (Ashland Advanced Materials, Bridgewater NJ; Type: EBT3), and a synthetic diamond diode type scanned point by point in air (PTW Models: MicroDiamond, MP3-P). The measured data were used as inputs to generate a Monte Carlo-based model for a commercial radiotherapy planning system (TPS) (Varian Medical Systems, Inc., Palo Alto, CA; Model: Eclipse v13.7.15). The regular ProBeat-V system (sigma ~2.5 mm) TPS model was available for comparison. A simulated base of skull case with small and medium targets proximal to brainstem was planned for both systems and compared. RESULTS The spot sigma is determined to be 1.4 mm at 221 MeV at the isocenter and below 1 mm at proximal distances. Integral depth doses were indistinguishable from the standard spot commissioning data. The TPS fit the spot profiles closely, giving a residual error maximum of 2.5% in the spot penumbra tails (below 5% of maximum) from the commissioned energies 69.4 to 221.3 MeV. The resulting IMMPT plans were more conformal than the IMPT plans due to a sharper dose gradient (90-10%) 1.5 mm smaller for the small target, and 1.3 mm for the large target, at a representative central axial water equivalent depth of 7 cm. CONCLUSIONS We developed, implemented, and tested a new IMMPT system. The initial results look promising in cases where treatments can benefit from additional dose sparing to neighboring sensitive structures.
Indole-3-acetylaspartate and indole-3-acetylglutamate, the IAA-amide conjugates in the diploid strawberry achene, are hydrolyzed in growing seedlings

Indole-3-acetylaspartate and indole-3-acetylglutamate are the stored auxin amino acid conjugates of the achene of the diploid strawberry and serve as sources of auxin during seedling growth. The edible part of the strawberry, a pseudocarp, has long been known to enlarge in response to auxin produced by the developing achenes, the botanical true fruit. Auxin homeostasis involves a complex interaction between biosynthesis, conjugate formation and hydrolysis, catabolism and transport. Strawberry tissues are capable of synthesizing auxin conjugates, and transcriptome data support the expression of genes involved in IAA conjugate formation and hydrolysis throughout embryo development and subsequent seedling growth. Using a highly sensitive and selective mass spectrometric method, we identified all the low molecular weight indole-auxin amino acid conjugates in achenes of F. vesca as consisting of indole-3-acetylaspartate (IAasp) and indole-3-acetylglutamate (IAglu). In contrast to what has been proposed to occur in Arabidopsis, we determined that IAasp and IAglu are hydrolyzed by seedlings to provide a source of free IAA for growth.
The oral health status of residents with different cognitive and dental-related functions in three North Carolina assisted living facilities.

Introduction The aim of the study was to describe the oral health status of persons with different cognition and dental-related functions (DRFs). Methods The present study was a secondary analysis of data collected for a cross-sectional study of residents in three assisted living facilities in North Carolina. The participants were aged 50 years or older, had normal to severely impaired cognition and spoke English. Upon obtaining informed consent, an oral assessment was completed by a trained geriatric dentist. A research team member who was blind to the oral examination outcomes then used the Minimum Data Set Cognition Scale to assess participants' cognition and the dental activities test to evaluate oral self-care and other DRFs. Descriptive statistics were used to describe the demographic, cognitive, functional and oral health status of the study participants. The impacts of cognitive and functional status on oral health measures were examined using simple linear regression models, negative binomial and zero-inflated negative binomial models. Results A total of 91 long-term residents from three long-term care facilities participated in the study. Oral hygiene and gingival health were significantly associated with cognition (P = 0.056 and P = 0.017, respectively) and DRFs (P = 0.013 and P = 0.008, respectively). Residents with poor cognitive and dental-related function also presented with poor oral hygiene and gingival health. Conclusion The study results suggest that oral hygiene and gingival health were significantly associated with cognition and DRFs.
The Influence of Parental Dieting Behavior on Child Dieting Behavior and Weight Status

To explore the relationship that parental dieting behavior (e.g., dieting, encouragement to diet, weight-teasing) has on child dieting behavior and weight status. Encouragement to diet and weight-teasing are both strong predictors of child dieting behavior in both childhood and adolescence. The impact of parent modeling of dieting behavior on child dieting behavior is mixed, but there is enough evidence to suggest that modeling is more impactful on daughters than sons and when parents are modeling unhealthy and extreme weight control behaviors (e.g., skipping meals). Parental dieting, both via modeling and increased use of encouragement to diet and weight-teasing, is associated with negative child eating and weight outcomes. Parental use of direct communication surrounding weight appears to be a more salient risk factor than parental modeling of dieting behavior. Future work is needed to develop strategies for parents to lower their child’s risk of dieting.
Plight of the pelvic exam

> I was worried about vaginas. I was worried what we think about vaginas, and I was even more worried that we don’t think about them. > — Eve Ensler, The Vagina Monologues 1 In recent years, a series of clinical studies have questioned the utility of the pelvic exam, and have concluded that it may be routinely omitted from patient evaluations in the ED. Tintinalli’s 2016 text states: ‘ Vaginal examinations in stable women presenting with first-trimester bleeding may add little to the clinical diagnosis; some providers are moving away from routine use of vaginal examinations in initial patient assessment as long as a transvaginal US is obtained .’2 A recent article in Emergency Medicine News was boldly entitled ‘Why Are You Still Performing Pelvic Exams?’ as if it were already an obsolete intervention.3 Yet a closer examination of the literature suggests these conclusions are far too premature. Several studies have evaluated the practice of obtaining a pelvic ultrasound in pregnant patients prior to, or possibly in lieu of, a pelvic exam. In 2017, Annals of Emergency Medicine published a study by Linden et al , suggesting that pelvic exams for ED patients with vaginal bleeding or lower abdominal pain, and ultrasound-confirmed first-trimester intrauterine pregnancy (IUP), may be unnecessary.4 This prospective, randomised equivalence trial measured the composite morbidity (unscheduled return, subsequent admission, emergency procedure, transfusion, infection and alternate source of symptoms) in the intervention (no pelvic exam) and control (pelvic exam performed) groups. The observed difference (−2.4% in the intervention arm) was not statistically significant, with a vast CI (−11.8% to 7.1%). The study was far underpowered: designed to involve 720 patients, it only enrolled 202 patients. Selection bias may have occurred: enrolment took place only on weekdays, for 15 hours/day; and language barriers were among their exclusion criteria, which may …
Improving compressive strength of high modulus carbon-fiber reinforced polymeric composites through fiber hybridization

Abstract There has been a strong demand in using high-modulus (HM) carbon-fiber composites potentially enabling lightweight aircraft structures with significant weight savings. However, extremely low fiber-direction compressive strength has been a well-recognized weakness of the HM composites, prohibiting their implementation in aircraft platforms. Hybridizing fibers with varying moduli provides an innovative means for improving the fiber-direction compressive strength of composites. This has been implemented by comingling intermediate-modulus (IM) and high-modulus (HM) carbon fibers in HM carbon fiber-reinforced polymer (CFRP) toughened with nano-silica. Comingling IM and HM fibers at the filament level in addition to the matrix nano-sized structural reinforcement throughout the composite, increases shear modulus to axial modulus ratio of the composite material, thus improving microstructural stability likely governing the fiber-direction compressive strength behavior. The basis for this new material design stems from the fact that fiber-direction compressive strength increases with the shear modulus to axial modulus ratio of composites across different fiber and resin combinations. The results demonstrate that the new hybrid HM composite fiber-direction compressive strength achieves that of IM legacy composites but with more than 30% higher axial modulus.
Effects of Force-Torque and Tactile Haptic Modalities on Classifying the Success of Robot Manipulation Tasks

We investigate which haptic sensing modalities, or combination of haptic sensing modalities, best enable a robot to determine whether it successfully completed a manipulation task. In this paper, we consider haptic sensing modalities obtained from a wrist-mounted force-torque sensor and three types of fingertip sensors: a pair of FlexiForce force-sensing resistors, a pair of NumaTac sensors, and a pair of BioTac sensors. For each type of fingertip sensor, we simultaneously record force-torque and fingertip tactile data as the robot attempted to complete two manipulation tasks—a picking task and a scooping task—two-hundred times each. We leverage the resulting dataset to train and test a classification method using forty-one different haptic feature combinations, obtained from exhaustive combinations of individual modalities of the force-torque sensor and fingertip sensors. Our results show that the classification method’s ability to distinguish between successful and unsuccessful task attempts depends on both the type of manipulation task and the subset of haptic modalities used to train and test the classification method.
Paternal morphine self-administration produces object recognition memory deficits in female, but not male offspring.

Parental drug use around or before conception can have adverse consequences for offspring. Historically, this research has focused on the effects of maternal substance use on future generations but less is known about the influence of the paternal lineage. This study focused on the impact of chronic paternal morphine exposure prior to conception on behavioral outcomes in male and female progeny. This study sought to investigate the impact of paternal morphine self-administration on anxiety-like behavior, the stress response, and memory in male and female offspring. Adult, drug-naive male and female progeny of morphine-treated sires and controls were evaluated for anxiety-like behavior using defensive probe burying and novelty-induced hypophagia paradigms. Hypothalamic-pituitary-adrenal (HPA) axis function was assessed by measuring plasma corticosterone levels following a restraint stressor in male and female progeny. Memory was probed using a battery of tests including object location memory, novel object recognition, and contextual fear conditioning. Paternal morphine exposure did not alter anxiety-like behavior or stress-induced HPA axis activation in male or female offspring. Morphine-sired male and female offspring showed intact hippocampus-dependent memory: they performed normally on the long-term fear conditioning and object location memory tests. In contrast, paternal morphine exposure selectively disrupted novel object recognition in female, but not male, progeny. Our findings demonstrate that paternal morphine taking produces sex-specific and selective impairments in object recognition memory while leaving hippocampal function largely intact.
Effect & Implications of Transcatheter Aortic Valve Replacement on Concomitant Functional Mitral Regurgitation

Moderate-to-severe concomitant mitral regurgitation (MR) is not uncommon in patients who undergo transcatheter aortic valve replacement (TAVR) for severe native aortic stenosis (AS). Frequently lef...
Analysis on the Effect of Secondary Side Devices for the Operation of GaN Based LLC Resonant Converter

This paper focuses on the LLC resonant converter working in the zero-voltage-switching (ZVS) region where the switching frequency (f s ) is larger than the resonant frequency (f r ). The secondary side devices critically affect both the normal operation and deadtime operation of the LLC converter. The effect of diode junction capacitance (C j ) and reverse recovery on the ZVS condition during deadtime has been discussed in the literature, but their effect on the waveform during normal operation has not. In this paper, a detailed description and analysis of deadtime operation with Silicon and Silicon Carbide (SiC) diodes are provided firstly and an accurate model for their effect on the following normal operation is derived based on the deadtime analysis. From the derived model, an improved ZVS condition for f s > f r region is presented, which can also provide the guideline for the selection of secondary side devices. To verify the proposed analysis and model, a 694 kHz/100 W GaN based LLC converter prototype with different secondary side devices is built and tested.
Multiband Parameter Estimation for Spectrum Sensing from Noisy Measurements

Under a dynamic spectrum access paradigm, a set of L spectrum bands licensed to primary users provide opportunities for an unlicensed secondary user to gain access to spectrum left idle by a primary user. We model the received noisy signal measurements on each band as a continuous-time Markov chain observed through a discrete-time Gaussian channel. Based on this model, we develop a scheme for estimating the parameters of the subset of L* <; L bands that offer the “best” opportunities for dynamic spectrum access in the sense of largest mean idle periods. Our approach consists of a Markov modulated Gaussian process model, an associated expectation-maximization algorithm, and a computing budget allocation scheme for allocating sensing effort across the spectrum bands over a sequence of observation intervals. The sensing effort allocation scheme maximizes the probability that the L* best bands will be determined from their parameter stimates obtained in the next observation interval. Simulation results are presented to demonstrate the performance of the proposed scheme.