cssi/SciSciGPT-SciSciNet huggingface dataset:
The Global Tracheostomy Collaborative: one institution's experience with a new quality improvement initiative

Abstract Objective Given the low frequency of adverse events after tracheostomy, individual institutions struggle to collect outcome data to generate effective quality improvement protocols. The Global Tracheostomy Collaborative (GTC) is a multi-institutional, multi-disciplinary organization that utilizes a prospective database to collect data on patients undergoing tracheostomy. We describe our institution's preliminary experience with this collaborative. It was hypothesized that entry into the database would be non-burdensome and could be easily and accurately initiated by skilled specialists at the time of tracheostomy placement and completed at time of patient discharge. Methods Demographic, diagnostic, and outcome data on children undergoing tracheostomy at our institution from January 2013 to June 2015 were entered into the GTC database, a database collected and managed by REDCap (Research Electronic Data Capture). All data entry was performed by pediatric otolaryngology fellows and all post-operative updates were completed by a skilled tracheostomy nurse. Tracked outcomes included accidental decannulation, failed decannulation, tracheostomy tube obstruction, bleeding/tracheoinnominate fistula, and tracheocutaneous fistula. Results Data from 79 patients undergoing tracheostomy at our institution were recorded. Database entry was straightforward and entry of patient demographic information, medical comorbidities, surgical indications, and date of tracheostomy placement was completed in less than 5 min per patient. The most common indication for surgery was facilitation of ventilation in 65 patients (82.3%). Average time from admission to tracheostomy was 62.6 days (range 0–246). Stomal breakdown was seen in 1 patient. A total of 72 patients were tracked to hospital discharge with 53 patients surviving (88.3%). No mortalities were tracheostomy-related. Conclusion The Global Tracheostomy Collaborative is a multi-institutional, multi-disciplinary collaborative that collects data on patients undergoing tracheostomy. Our experience proves proof of concept of entering demographics and outcome data into the GTC database in a manner that was both accurate and not burdensome to those participating in data entry. In our tertiary care, pediatric academic medical center, tracheostomy continues to be a safe procedure with no major tracheostomy-related morbidities occurring in this patient population involvement with the GTC has shown opportunities for improvement in communication and coordination with other tracheostomy-related disciplines.
Analytic Thermal Design of Bitter-Type Solenoids

We describe an analytic approach to designing axially water-cooled Bitter-type electromagnets with an emphasis on heat dissipation considerations. The design method here described aims to enhance the efficiency of the design process by minimizing the role of finite element analysis (FEA) software. A purely analytic design optimization scheme is prescribed for establishing the cooling hole placement. FEA software is only used to check the accuracy of analytic predictions. The analytic method derived in this paper predicts the required heat dissipation rate by approximating the volumetric joule heating profile with a smooth, continuous profile. Equations for turbulent convective heat transfer in circular ducts are generalized to model the cooling capacity of elongated cooling passages. This method is currently in use at the University of Maryland Baltimore County Dusty Plasma Laboratory to design a Bitter magnet capable of generating fields of 10 T.
Sampling theorem for functions bandlimited to a disc

The Whittaker-Shannon-Kotel'nikov sampling theorem provides sampling series expansions for the re-construction of functions (signals) that are bandlimited to finite closed intervals, symmetric about the origin, i.e., intervals of type [−a,a]. There are generalizations of this theorem to Ndimensions, yet they all mainly deal with functions that are also bandlimited to N-dimensional rectangles symmetric about the origin. No general theory seems to exist for functions that are bandlimited to a general domain in Ndimensions. In this paper we give, by using polar coordinates, a sampling series expansion that can be used for the reconstruction of functions (signals) that are bandlimited to a disc centered at the origin. The sample points are the eigenvalues of a Dirichlet problem in the disc.
Anticipated Foundation Movement Affects Design

Anticipated foundation movements resulting from removal of heavy overburden loads from overconsolidated soils initiated special considerations of construction sequence and structural details for Dos Amigos Pumping Plant in California. Progressive unloading and reloading of the foundation is controlled by the construction specifications for this 13,200 cfs pumping plant. The possibility of relatively large differential movements across building expansion joints and between the structure and the discharge pipeline foundation is recognized. Special details for embedded pipe and conduit are developed to provide articulation across the building expansion joints. Articulation of the discharge pipeline between the building and the pipeline foundation is also developed.
The North Country on the Job Network: a unique role for occupational health nurses in a community coalition.

1. Through a community based program, nurses were hired by a rural medical center to facilitate care for injured workers in the community. This placed the nurses outside the industrial and insurance arenas. 2. Rapid access to care and expedited return to work were made possible largely through improved communication, facilitated by the nurse case coordinators, among all involved parties (i.e., workers, employers, health care providers, insurance carriers). 3. The program provides access to occupational health nurses, or case managers, to a large number of rural workers--many of whom work for small employers and would not have these services otherwise. 4. The simple administrative model has resulted in increased numbers of workers returning to work with decreasing numbers of transitional or modified duty days.
Mayhem in Social Media

This paper recounts Allstate’s transition from traditional to social media marketing, including its use of the brand character, ‘Mayhem’. Allstate maintained a dual-brand presence by having separate social media accounts for its brand and brand character on platforms such as Twitter and Facebook. Although Mayhem’s popularity varied across platforms, the addition of the character to Allstate’s social media presence resulted in significant increases in popularity for both the brand and Mayhem. This paper identifies factors potentially affecting the success of brand characters in social media. It closes with a discussion on managerial implications that includes three key points for managers to consider when using a brand character in social media.
Measurement of carrier NH3 in ammonia N13 injection

1196 Objectives Ammonia N13 injection is prepared as a carrier free solution for cardiac imaging. We questioned whether 13NH3 is carrier free. The assessment of carrier NH3 is an important quality assurance test. Under air-equilibrated irradiation conditions, we found an amount of carrier that exceeded the limits of NH3 in sterile water for injection (SWI) and sought to determine the source of this carrier. Methods We prepare 13NH3 by the irradiating SWI containing 5 mM ethanol. Our target body is Al (~3 mL) with a Ti window; the target is cooled with circulating 54°F water. We typically irradiate for 10 min x 30 µA of 11 MeV H+. The assay for carrier NH3 uses ion chromatography (Dionex IonPac C14 column) with a conductivity detector and anion suppression and was done prior to making it isotonic. Results Under normal irradiation conditions with 5 mM ethanol solution sterile-filter vented to air, the NH3 in product is ~1.5 µg/mL or ~ 4 GBq/µmol at EOB, an amount well below theoretical specific activity and above the USP limit for NH3 in SWI. The mass correlated with the amount of beam (µA x min) with a near-zero intercept. 5 mM ethanol held in the target for the time of a typical bombardment but without beam produced Conclusions Nucleogenic 13N atoms from the 16O(p,α)13N nuclear reaction are formed with high energy and charge and, in pure H2O produce oxidized products. However, the highly reducing environment caused by radiation chemistry in the target converts nitrate and nitrite to NH3 and this conversion is aided by addition of ethanol. Our results showed that radiation chemistry also converts N2 to NH3, a reaction that has not been previously reported in the cyclotron targetry literature. Water solutions for making 13NH3 at high beam current should be degassed prior to irradiation, especially for low E accelerators where the GBq yields require a large fraction of the target product for an individual patient dose. Research Support Supported by NIH grants P01 CA42045 and RR17229.
Reason, Authority and Science

Despite his numerous mathematical and scientific achievements, Pascal is perhaps most famous for his posthumously published Pensees, and also for his pseudonymously written Provincial Letters. The former is an incomplete set of notes which Pascal had been preparing as an apology, or defense, of the Christian religion prior to his early death. The latter are a series of polemical letters, published in Paris during the years 1656 and 1657, which satirized the casuistry of Pascal’s Jesuit opponents, and which defended a Jansenist understanding of salvation, to which Pascal himself adhered. Pascal’s concern with theology, and specifically its relationship to other fields of inquiry (such as natural science) is apparent in his Preface to the Treatise on the Vacuum.
X-ray Spectroscopic Studies of the Bulk Electronic Structure of InGaN Alloys

Synchrotron radiation excited soft x-ray emission and soft x-ray absorption spectroscopies are applied to the study of the electronic structure of In x Ga 1-x N alloys with (0 ≤ x ≤ 0.29). The elementally resolved partial density of states of the valence and conduction bands may be measured using these spectroscopies. The x-ray absorption spectra indicate that the conduction band broadens considerably with increasing indium incorporation. The band gap evolution as a function of indium content derives primarily from this broadening of the conduction band states. The emission spectra indicate that motion of the valence band makes a smaller contribution to the evolution of the band gap. This gap evolution differs from previous studies on the Al x Ga 1-x N alloy system, which observed a linear valence band shift through the series (0 x x Ga 1-x N the valence band exhibits a significant shift between x = 0 and x = 0.1 with minimal movement thereafter. Furthermore, evidence of In 4d -N 2p and Ga 3d- N 2p hybridisation is reported. Finally, the thermal stability of an In 0 11 Ga 0 89 N film was investigated. Both emission and absorption spectra were found to have a temperature dependent shift in energy, but the overall definition of the spectra was unaltered even at annealing temperatures well beyond the growth temperature of the film.
Aluminum Cluster Anion Reactivity with Singlet Oxygen: Evidence of Al9– Stability

Recently, it was discovered that specific aluminum clusters (e.g., Al13–) that demonstrate enhanced resistance to reactivity with oxygen may do so not only because of a closed electronic jellium shell as originally supposed but also because of a forbidden spin-flip in the transition state of the reaction. Herein, we discuss an experiment using a multiple-species laminar flow reaction vessel coupled to a singlet oxygen generator. The present results suggest that all clusters react with singlet oxygen. Additionally, we observe Al9–, a cluster previously unidentified as having any notable stability, as being resistant to reaction with triplet oxygen. Furthermore, we discuss a means of estimating rate constants in a multiple-species flow tube where the products and reactants do not allow the use of traditional methods.
Salience of Compositional Cues and the Order of Presentation in the Picture Reversal Effect

Paintings containing cues suggesting left-to-right (LTR) motion are preferred by dextrals over their mirror-reversed versions (RTL) in forced-choices between the simultaneously-presented alternatives. To eliminate a simultaneous-contrast interpretation of the effect and to determine whether motion cues influence choice when paintings are seen alone, a successive-presentation procedure was used. When an LTR version preceded the RTL version, the LTR version was preferred within the pair by dextrals and also was preferred more frequently than RTL versions shown first Thus, these compositional features of single versions were noticed and affected judgment. An order-of-presentation effect was also found, in that the first member of a pair was preferred. Possible explanations for this are considered.
Efficient asymmetric synthesis of Tryptophan Analogues having useful Photophysical properties

Two new fluorescent probes of protein structure and dynamics have been prepared by concise asymmetric syntheses using the Schollkopf chiral auxiliary. The site-specific incorporation of one probe into dihydrofolate reductase is reported. The utility of these tryptophan derivatives lies in their absorption and emission maxima which differ from those of tryptophan, as well as in their large Stokes shifts and high molar absorptivities.
Time function for borehole explosive loading and specific energy based on different coupling mediums

To improve explosive crushing effect and control explosive vibration through selection of coupling mediums,the calculation models of explosive loading and specific energy were established under different coupling mediums of explosion source.The time function and curve of explosive loading and specific energy in rock medium were calculated with programming.The results showed that: the initial borehole explosive loading is the maximum,but its attenuation is also the fastest when using coupling charge;although that is smaller in water decoupling charge,its attenuation is the slowest;the specific energy of water decoupling charge is the maximum,that of water coupling charge is smaller;while both of barehole explosive loading and specilfic energy of air and soil-decoupling charge are minimum.So water decoupling charge was good for improving blasting crushing effect and bad for controlling blasting vibration.
Pain syndromes in the cancer patient.

In evaluating the cancer patient with a pain complaint, a knowledge of common syndromes that affect this population is invaluable. Pain is frequently the initial and sometimes the only manifestation of tumor involving critical neurologic structures. Prompt evaluation of pain complaints in the cancer patient may avoid irreversible neurologic complications and may lead to earlier treatment of the cancer. Therefore, compulsive evaluation of pain complaints is frequently indicated. This article reviews common pain syndromes in the cancer patient, with strong emphasis on related neurologic dysfunction.
Improvement in Camptocormia Following Botulinum Toxin Injection to the External Oblique Muscle (P06.105)

OBJECTIVE: To describe a case of camptocormia refractory to onabotulinumtoxin-A(BTX) injection to the rectus abdominis(RA) muscle, that responded well to external oblique(EO) injection. BACKGROUND: Camptocormia is an abnormal forward flexion of the thoracolumbar spine that increases when standing or walking and abates or disappears in the recumbent position. The RA muscles are most commonly injected with BTX for treatment of dystonic camptocormia. DESIGN/METHODS: A 66 year old woman with Parkinson9s disease(PD) for 7 years presented with camptocormia for two years with painful abdominal contractions. She had a past left Transverse Rectus Abdominis Myocutaneous (TRAM) flap procedure for breast reconstruction. Baseline examination was remarkable for scoliosis and 45-degree forward flexion of the spine and MDS-UPDRS of 64. There were palpable abdominal contractions when standing and she could not lie flat on her back. Camptocormia did not improve with sensory tricks. Titration of PD medications partially improved symptoms, and adjunctive BTX injections were performed. RESULTS: 200 units of BTX were injected under EMG guidance to each RA muscle. EMG activity during voluntary contraction of the RA was robust on the right and minimal on the left. 8 weeks later, there was marked reduction in right but not left abdominal painful contractions and minimal improvement in posture. CT scan of the abdomen confirmed surgical excision of the left RA, which measured 2-6 mm in thickness, compared to 6-9mm on the right. Subsequent EMG guided BTX injection of 200 units to the left EO and 200 units to the right RA resulted in more robust improvement. Compensated truncal flexion was 20degrees, she could lie flat on the exam table, and could stand erect with a sensory trick. CONCLUSIONS: EO muscle injections should be considered in cases of dystonic camptocormia refractory to usual RA injections. Disclosure: Dr. Wijemanne has nothing to disclose. Dr. Jimenez-Shahed has received personal compensation for activities with Teva Neuroscience, Allergan, Inc, Merz Pharma, Medtronic, Inc., and Lundbeck.
Stream Control for Interfering MIMO Links with Linear MMSE Receivers

Recent work has shown that the throughput performance of Wireless Local Area Networks (WLANs) can be significantly improved with the use of multiple-input and multiple-output (MIMO) links. This paper investigates the network throughput for different MIMO transmission schemes with linear MMSE receivers. Simulated throughput of two-link network topology suggests that stream control mechanism wherein an additional streams is added if it leads to an increment in the network throughput can improve the performance of interfering MIMO links, making them an attractive alternative to a TDMA fashion network. The performance of OL- MIMO can be further improved with optimal antenna selection. Our results further show that stream control renders significant throughput gain across a wide range of target bit-error rates (BER).
Development of a Mobile Toolmark Characterization/Comparison System.

Since the development of the striagraph, various attempts have been made to enhance forensic investigation through the use of measuring and imaging equipment. This study describes the development of a prototype system employing an easy-to-use software interface designed to provide forensic examiners with the ability to measure topography of a toolmarked surface and then conduct various comparisons using a statistical algorithm. Acquisition of the data is carried out using a portable 3D optical profilometer, and comparison of the resulting data files is made using software named “MANTIS” (Mark and Tool Inspection Suite). The system has been tested on laboratory-produced markings that include fully striated marks (e.g., screwdriver markings), quasistriated markings produced by shear-cut pliers, impression marks left by chisels, rifling marks on bullets, and cut marks produced by knives. Using the system, an examiner has the potential to (i) visually compare two toolmarked surfaces in a manner similar to a comparison microscope and (ii) use the quantitative information embedded within the acquired data to obtain an objective statistical comparison of the data files. This study shows that, based on the results from laboratory samples, the system has great potential for aiding examiners in conducting comparisons of toolmarks.
Advanced Analysis Techniques for the Optimum Design of Clean Rooms

This paper describes the application of advanced vibration analysis techniques and computational modeling to the design of microelectronics clean rooms. The ASAS (Atkins Stress Analysis System) and ASIST computer models were used to perform dynamic finite element analyses to determine the effects of transmitted structural forces on sensitive photolithographic equipment. The CAFE (Computer Aided Flow Evaluation) computer program was used to recirculate flow problems and evaluate the influences of representative obstructions on laminar air flow. Results of both analyses are presented.
Neuromodulation based on rTMS affects behavioral measures and autonomic nervous system activity in children with autism

Many children with autism spectrum disorder (ASD) exhibit symptoms associated with autonomic nervous system (ANS) dysfunction indicative of low psychophysiological flexibility. It is suggested that ASD symptoms are associated with generalized abnormalities in the central nervous system, including structures and networks involved in the top-down regulation of the ANS. Repetitive transcranial magnetic stimulation (rTMS) has been suggested as a possible therapy to target ANS regulation deficits in ASD. In the current study we used neuromodulation based on rTMS over the dorsolateral prefrontal cortex (DLPFC) to reduce sympathetic arousal and increase parasympathetic activity in children with ASD. In a study on 27 children with autism we administered weekly 0.5 Hz rTMS bilaterally over the DLPFC with concurrent recording of autonomic activity. Statistical analysis of time and frequency domain heart rate variability (HRV) indices and skin conductance level (SCL) revealed a strong linear regression of most HRV and SCL measures. Several parental behavioral rating scores improved post-TMS and showed a correlation with autonomic outcomes, in particular parasympathetic indices of HRV negatively correlated with repetitive and stereotyped behaviors, while sympathetic arousal indices showed positive correlation with the same behaviors. The paper discusses potential neurobiological mechanisms involved in post-TMS autonomic balance and aberrant behavior improvements.
Compact Modeling of Graphene Barristor for Digital Integrated Circuit Design

Graphene barristor, in which a Schottky barrier formed between graphene layer and silicon layer can widen the bandgap with the control of gate voltage, is a promising method to enhance on/off current ratio in digital circuit design. In this work, a theoretical study is presented based on analog behavior modeling in SPICE. We have developed a compact device model to evaluate the performance of graphene barristors. The device simulation results show the on/off current ratio nearly 105 under the voltage variation which agrees closely with the reported experimental results. A complementary inverter is designed using the developed model to prove the feasibility of graphene barristor for use in future digital VLSI design. The energy per switching is between 1.1±0.52fJ under voltage variation.
Thermal neutron scattering law calculations using ab initio molecular dynamics

In recent years, methods for the calculation of the thermal scattering law (i.e. S(α,β), where α and β are dimensionless momentum and energy transfer variables, respectively) were developed based on ab initio lattice dynamics (AILD) and/or classical molecular dynamics (CMD). While these methods are now mature and efficient, further advancement in the application of such atomistic techniques is possible using ab initio molecular dynamics (AIMD) methods. In this case, temperature effects are inherently included in the calculation, e.g. phonon density of states (DOS), while using ab initio force fields that eliminate the need for parameterized semi-empirical force fields. In this work, AIMD simulations were performed to predict the phonon spectra as a function of temperature for beryllium and graphite, which are representative nuclear reactor moderator and reflector materials. Subsequently, the calculated phonon spectra were utilized to predict S(α,β) using the LEAPR module of the NJOY code. The AIMD models of beryllium and graphite were 5 × 5 × 5 crystal unit cells (250 atoms and 500 atoms respectively). Electronic structure calculations for the prediction of Hellman-Feynman forces were performed using density functional theory with a GGA exchange correlation functional and corresponding core electron pseudopotentials. AIMD simulations of 1000–10,000 time-steps were performed with the canonical ensemble (NVT thermostat) for several temperatures between 300 K and 900 K. The phonon DOS were calculated as the power spectrum of the AIMD predicted velocity autocorrelation functions. The resulting AIMD phonon DOS and corresponding inelastic thermal neutron scattering cross sections at 300 K, where anharmonic effects are expected to be small, were found to be in reasonable agreement with the results generated using traditional AILD. This illustrated the validity of the AIMD approach. However, since the impact of the temperature on the phonon DOS (e.g. broadening of spectral peaks) was observed in AIMD analysis, this technique may be envisioned as the approach for deriving the needed atomistic data for thermal scattering law calculations under realistic temperature and structural conditions for a given material.
Changes in the microbiota cause genetically modified Anopheles to spread in a population

The mosquito’s innate immune system controls both Plasmodium and bacterial infections. We investigated the competitiveness of mosquitoes genetically modified to alter expression of their own anti-Plasmodium immune genes in a mixed-cage population with wild-type mosquitoes. We observed that genetically modified mosquitoes with increased immune activity in the midgut tissue did not have an observed fitness disadvantage and showed reduced microbial loads in both the midgut and reproductive organs. These changes result in a mating preference of genetically modified males for wild-type females, whereas wild-type males prefer genetically modified females. These changes foster the spread of the genetic modification in a mosquito cage population.
Early major complications after bariatric surgery in the USA, 2003-2014: a systematic review and meta-analysis.

The effectiveness of bariatric surgery has been well-studied. However, complications after bariatric surgery have been understudied. This review assesses <30-d major complications associated with bariatric procedures, including anastomotic leak, myocardial infarction and pulmonary embolism. This review included 71 studies conducted in the USA between 2003 and 2014 and 107,874 patients undergoing either gastric bypass, adjustable gastric banding or sleeve gastrectomy, with mean age of 44 years and pre-surgery body mass index of 46.5 kg m-2 . Less than 30-d anastomotic leak rate was 1.15%; myocardial infarction rate was 0.37%; pulmonary embolism rate was 1.17%. Among all patients, mortality rate following anastomotic leak, myocardial infarction and pulmonary embolism was 0.12%, 0.37% and 0.18%, respectively. Among surgical procedures, <30-d after surgery, sleeve gastrectomy (1.21% [95% confidence interval, 0.23-2.19%]) had higher anastomotic leak rate than gastric bypass (1.14% [95% confidence interval, 0.84-1.43%]); gastric bypass had higher rates of myocardial infarction and pulmonary embolism than adjustable gastric banding or sleeve gastrectomy. During the review, we found that the quality of complication reporting is lower than the reporting of other outcomes. In summary, <30-d rates of the three major complications after either one of the procedures range from 0% to 1.55%. Mortality following these complications ranges from 0% to 0.64%. Future studies reporting complications after bariatric surgery should improve their reporting quality.
Prognostic Significance of Stringent Complete Response after Stem Cell Transplantation in Immunoglobulin Light Chain Amyloidosis.

Abstract Hematologic response has emerged as a powerful prognostic factor for survival in patients with immunoglobulin light chain (AL) amyloidosis. Patients achieving a complete response (CR), based on serum and urine analysis, survive longest. However, data regarding the impact of bone marrow features post-therapy on response and survival are limited. We evaluated the impact of achieving a stringent CR (sCR), defined as undetectable bone marrow clonal plasma cells by flow cytometry, in patients with AL amyloidosis receiving an autologous stem cell transplant. A total of 573 consecutive patients transplanted for AL amyloidosis at the Mayo Clinic between April 2002 and August 2016 were included in the analysis. Of 540 patients in whom response was assessable, 220 patients (41%) achieved a CR, of whom 212 (96%) had a bone marrow biopsy at time of response assessment and were further analyzed for determination of sCR; 166 patients (78%) with a CR achieved an sCR, representing 31% of the whole cohort. Patients achieving a CR had a higher median percentage of bone marrow plasma cells (10% for CR versus 6% for sCR, P = .03), more patients with bone marrow plasma cells ≥ 10% (50% for CR versus 33% for sCR, P = .04), and were less likely to receive chemotherapy before transplantation (30% for CR versus 49% for sCR, P = .03) compared with those achieving sCR. Median overall survival for all patients achieving a CR was 175 months and was not statistically different between those achieving an sCR compared with those achieving a CR only (median not reached for sCR versus 175 months for CR, P = .65). Progression-free survival, however, was significantly shorter in patients failing to achieve an sCR (151 months for sCR versus 72 months for CR, P = .0003). Bone marrow examination post-transplant in AL amyloidosis is important and identifies patients who fail to achieve an sCR and progress earlier.
How to Fix the Google Book Search Settlement

The proposed settlement in the Google Book Search case should be approved with strings attached. The project will be immensely good for society, and the proposed deal is a fair one for Google, for authors, and for publishers. The public interest demands, however, that the settlement be modified first. It creates two new entities - the Books Rights Registry Leviathan and the Google Book Search Behemoth - with dangerously concentrated power over the publishing industry. Left unchecked, they could trample on consumers in any number of ways. We the public have a right to demand that those entities be subject to healthy, pro-competitive oversight, and so we should.
The lateral limited thoracotomy incision: standard for pulmonary operations.

Four hundred sixty-eight consecutive thoracotomies for which the lateral limited thoracotomy incision was used are reviewed (1978 to 1988). The limited incision is a lateral muscle-splitting incision with preservation of the latissimus dorsi, splitting of the serratus anterior, and cutting of only the intercostal muscles without rib resection. Patients were designated unsuitable for operation if (1) biopsy-proved distant metastasis existed, (2) mediastinoscopy revealed extranodal metastasis, or (3) severe respiratory compromise resulted in shortness of breath at rest with a forced expiratory volume in 1 second of less than 0.75 L (four patients). Mean patient age was 60.9 (±15.7) years. Surgical procedures included lobectomy (n = 317), pneumonectomy (n = 41), wedge resection (n = 82), resections of blebs or bullae (n = 17), thoracotomy and biopsy for unresectable lesion (n = 6), and decortication (n = 5). Pathologic analysis revealed 354 malignant tumors, 102 benign lesions, and 12 carcinoids. The perioperative mortality rate was 0.85% (4/468) and major morbidity was present in 2.9% (14/468). Mean operative time was 73.1 (± 32.2) minutes with a blood loss resulting in a mean decrease of the hematocrit value of 2.6 (± 2.5) gm; three patients were given a total of 7 units of blood. Most patients do not require a stay in the intensive care unit postoperatively (less than 10%). Hospital stay postoperatively was a mean of 6.1 (±2.9 days. The limited incision is a significant factor in decreasing operative time, blood loss, postoperative pain and morbidity, and cost.
Mechanistic science: A new approach to comprehensive psychopathology research that relates psychological and biological phenomena

Efforts to understand the causes of psychopathology have remained stifled in part because current practices do not clearly describe how psychological constructs differ from biological phenomena and...
Building a cancer registry performance dashboard by leveraging existing workflow documents at a comprehensive cancer center.

296Background: Quantifying the performance of a cancer center’s cancer registry is important to plan for resources needed to address shortcomings and projected increases in workload. The objective ...
The biology of the extracorporeal vasculature of Botryllus schlosseri.

Abstract The extracorporeal vasculature of the colonial ascidian Botryllus schlosseri plays a key role in several biological processes: transporting blood, angiogenesis, regeneration, self-nonself recognition, and parabiosis. The vasculature also interconnects all individuals in a colony and is composed of a single layer of ectodermally-derived cells. These cells form a tube with the basal lamina facing the lumen, and the apical side facing an extracellular matrix that consists of cellulose and other proteins, known as the tunic. Vascular tissue is transparent and can cover several square centimeters, which is much larger than any single individual within the colony. It forms a network that ramifies and expands to the perimeter of each colony and terminates into oval-shaped protrusions known as ampullae. Botryllus individuals replace themselves through a weekly budding cycle, and vasculature is added to ensure the interconnection of each new individual, thus there is continuous angiogenesis occurring naturally. The vascular tissue itself is highly regenerative; surgical removal of the ampullae and peripheral vasculature triggers regrowth within 24–48 h, which includes forming new ampullae. When two individuals, whether in the wild or in the lab, come into close contact and their ampullae touch, they can either undergo parabiosis through anastomosing vessels, or reject vascular fusion. The vasculature is easily manipulated by direct means such as microinjections, microsurgeries, and pharmacological reagents. Its transparent nature allows for in vivo analysis by bright field and fluorescence microscopy. Here we review the techniques and approaches developed to study the different biological processes that involve the extracorporeal vasculature.
Analysis of 24-hour surgical cancellations in an academic rhinology and skull base surgery practice

Background Late cancellations within 24 hours of surgery lead to decreased utilization of operating room time with loss of productivity, decreased access to care, and inconvenience to patients and staff. To date, no studies have analyzed 24-hour cancellations in a tertiary rhinology practice. Methods All procedures performed at a tertiary rhinology/skull base practice from January 2016 to December 2017 were reviewed. Twenty-four-hour cancellations were analyzed by procedure type and reason for cancellation. Avoidable cancellations were late cancellations that could have been prevented by review of medical records or communication by hospital staff with the patient before surgery. Univariate analysis was performed to determine predictive factors for cancellations. Results A total of 39 of 640 surgical cases were cancelled (6.1%) within 24 hours of surgery. Of these, 69.2% were inflammatory and 30.8% were skull base cases. The mean number of operating room minutes lost was 151 (60 of 210) for inflammatory and 263 (102 of 480) for skull base cases. Avoidable cancellations were seen in 25 of 35 (71.4%) cases. Patients undergoing inpatient or skull base surgery were more likely to have medical cancellations than patients undergoing outpatient or inflammatory surgery (91.7% vs 43.5%, p = 0.01; 83.3% vs 47.8%, p = 0.07). Conclusion This is the first study to analyze 24-hour cancellations in tertiary rhinology/skull base surgery. The results suggest that a majority of late cancellations are avoidable and that skull base and inpatient surgeries are more likely to be canceled for medical reasons. Further studies are required to better characterize surgical cancellations in rhinology and identify strategies to try to prevent them.
Emergency Department Visits for Opioid Overdoses Among Patients With Cancer.

BACKGROUND Patients with cancer may be at risk of high opioid use due to physical and psychosocial factors, although little data exist to inform providers and policymakers. Our aim is to examine overdoses from opioids leading to emergency department (ED) visits among patients with cancer in the United States. METHODS The Healthcare Cost and Utilization Project Nationwide Emergency Department Sample was queried for all adult cancer-related patient visits with a primary diagnosis of opioid overdose between 2006 and 2015. Temporal trends and baseline differences between patients with and without opioid-related ED visits were evaluated. Multivariable logistic regression analysis was used to identify risk factors associated with opioid overdose. All statistical tests were two-sided. RESULTS Between 2006 and 2015, there were a weighted total of 35 339 opioid-related ED visits among patients with cancer. During this time frame, the incidence of opioid-related ED visits for overdose increased twofold (P < .001). On multivariable regression (P < .001), comorbid diagnoses of chronic pain (odds ratio [OR] 4.51, 95% confidence interval [CI] = 4.13 to 4.93), substance use disorder (OR = 3.54, 95% CI = 3.28 to 3.82), and mood disorder (OR = 3.40, 95% CI = 3.16 to 3.65) were strongly associated with an opioid-related visit. Patients with head and neck cancer (OR = 2.04, 95% CI = 1.82 to 2.28) and multiple myeloma (OR = 1.73, 95% CI = 1.32 to 2.26) were also at risk for overdose. CONCLUSIONS Over the study period, the incidence of opioid-related ED visits in patients with cancer increased approximately twofold. Comorbid diagnoses and primary disease site may predict risk for opioid overdose.
Testing the effects of a pilot listening comprehension and vocabulary intervention for individuals with autism

Abstract Many school-age children with autism spectrum disorder (ASD) experience difficulties with reading comprehension, yet few studies have examined intervention practices to support their early reading comprehension development. The current study used a small randomly assigned treatment control design (N = 12) to investigate the preliminary effects of a listening comprehension intervention on narrative retell, vocabulary, and listening comprehension skills for students with ASD. Children who received the intervention grew significantly on proximal measures of these skills. Significant group differences were noted at post-test on narrative retell ability. Although preliminary, these findings suggest that storybook-based interventions that target the oral language and social-cognitive underpinnings of comprehension development may be successful for school-age children with ASD.
Bridging gaps and moving forward: Building a new model for socioemotional formation and regulation

Collaboration is an important lifelong and career skill, and collaborative learning is a growing pedagogical practice. Students often struggle, however, to negotiate, manage conflict, and construct...
The Journalist's Speech: A Phenomenological Study of Stuttering in the Newsroom

Journalists commonly advocate for newsroom diversity and inclusivity. Yet stuttering, a speech disability affecting nearly 1% of the population, is seldom referenced in diversity training materials...
8.03 – Tracheobronchial Airways*

This chapter provides an overview of the architecture, function, and cellular composition of the airways. In particular, the role of anatomical diversity of airways among mammalian species will be addressed along with methods to evaluate normal airway function and response to toxic injury from an anatomical perspective.
Numerical Transfer Matrix Studies of Ising Models

Numerical transfer matrix methods are introduced which give scaling results for Ising models in high dimensions (d ≤ 7) and for dimensions between 1 and 2. Results for both the critical temperature and the thermal critical exponent are presented.
Organization, Function, and Development of the Mouse Retinogeniculate Synapse

Visual information is encoded in distinct retinal ganglion cell (RGC) types in the eye tuned to specific features of the visual space. These streams of information project to the visual thalamus, the first station of the image-forming pathway. In the mouse, this connection between RGCs and thalamocortical neurons, the retinogeniculate synapse, has become a powerful experimental model for understanding how circuits in the thalamus are constructed to process these incoming lines of information. Using modern molecular and genetic tools, recent studies have suggested a more complex circuit organization than was previously understood. In this review, we summarize the current understanding of the structural and functional organization of the retinogeniculate synapse in the mouse. We discuss a framework by which a seemingly complex circuit can effectively integrate and parse information to downstream stations of the visual pathway. Finally, we review how activity and visual experience can sculpt this exquisite connectivity.
Rapid and Scalable Profiling of Nascent RNA with fastGRO.

Summary Genome-wide profiling of nascent RNA has become a fundamental tool to study transcription regulation. Unlike steady-state RNA-sequencing (RNA-seq), nascent RNA profiling mirrors real-time activity of RNA polymerases and provides an accurate readout of transcriptome-wide variations. Some species of nuclear RNAs (i.e., large intergenic noncoding RNAs [lincRNAs] and eRNAs) have a short half-life and can only be accurately gauged by nascent RNA techniques. Furthermore, nascent RNA-seq detects post-cleavage RNA at termination sites and promoter-associated antisense RNAs, providing insights into RNA polymerase II (RNAPII) dynamics and processivity. Here, we present a run-on assay with 4-thio ribonucleotide (4-S-UTP) labeling, followed by reversible biotinylation and affinity purification via streptavidin. Our protocol allows streamlined sample preparation within less than 3 days. We named the technique fastGRO (fast Global Run-On). We show that fastGRO is highly reproducible and yields a more complete and extensive coverage of nascent RNA than comparable techniques can. Importantly, we demonstrate that fastGRO is scalable and can be performed with as few as 0.5 × 106 cells.
Radius of Curvature in Patient-Specific Short Rod Constructs Versus Standard Pre-Bent Rods.

ABSTRACT Background: Recent studies support the need for sagittal alignment restoration when performing lumbar degenerative spinal fusions. The development of patient-specific spine rods (PSSRs) may help maintain or improve sagittal alignment in these surgeries. Methods: A retrospective review was conducted for patients who underwent posterior spinal surgeries involving 4 or less levels. The preplanned PSSR radii of curvature (ROC) was compared with standard prebent rods with a ROC of 125 mm. All surgeries were performed at a single institution by 3 surgeons from September 2016 through October 2018. Data were then compared using a 2-tailed paired t test. PSSR had either 1 or 2 definitive ROCs. Results: For rods with 2 ROCs, the “cranial” curve was measured between the upper instrumented level and L4 or L5. The “caudal” curve was measured between L4 or L5 and the lower instrumented level. The PSSR with 1 ROC and the caudal portion of the rods with 2 ROCs were significantly smaller than the industry standard ROC. Conclusions: PSSR demonstrate more acute ROC than industry standard rods. In PSRs, the most lordosis occurs between L4-S1 and flattens out at the thoracolumbar junction, mimicking the normal distribution of lumbar lordosis. PSSRs could help achieve or maintain sagittal alignment and prevent the sequela of flat back syndrome.
Does Medicine Have Common Goals? An Analysis of US Medical Organizations' Ethics Statements.

Background:A philosophical framework defines medicine. Multiple competing frameworks lead to varying and sometimes conflicting understandings of the physician–patient relationship, medicine’s goals...
Juvenile cystic adenomyoma, a rare diagnostic challenge: Case Reports and literature review.

Objective To report 2 very rare cases of young women who presented with severe dysmenorrhea and a large cystic lesion in the myometrium, which presented a diagnostic dilemma because they were confused with a Mullerian anomaly. Design Case reports and a literature review. Setting A university-based reproductive endocrinology and infertility clinic in the United States. Patient(s) An 18- and a 16-year-old nulliparous girl presented with worsening of their longstanding pelvic pain, and imaging study results were suggestive of a Mullerian anomaly. Intervention(s) Abdominal and pelvic computed tomography, transvaginal ultrasonography, pelvic magnetic resonance imaging, operative laparoscopy, and excision of a juvenile cystic adenomyoma (JCA). Main Outcome Measure(s) Resolution of the pelvic pain and restoration of normal uterine anatomy after appropriate intervention Result(s) Restoration of normal uterine anatomy, which was confirmed by 3-dimensional ultrasonography for case 1; however, case 2 still had a small remnant of JCA postoperatively. Conclusion(s) Clinical and radiologic examinations may not be useful in differentiating a Mullerian anomaly from other rare abnormalities like JCA. When in doubt, laparoscopy can assist in diagnosing and treating the condition.
Pacific National Industries, Inc.

Eric Walsh, newly promoted director of aviation for Pacific National Industries, Inc. (PNI), is one week away from having to make his very first presentation to the company's COO and CFO. PNI is one of the country's largest chemical companies, and maintained four aircraft and a team of flight and maintenance crewmembers to facilitate executive travel to and from the company's many plants and operating complexes. Walsh enters his new position and learns how badly the aviation division needs updating: the planes need refurbishment or replacement, the staff might need retraining, and PNI has just acquired a new company that comes with its own flight division—so Walsh also needs to figure out how that fleet factors into PNI's existing one, if at all. With only a week left to prepare for his meeting, Walsh must decide where to focus his presentation. Excerpt UVA-G-0646 Apr. 18, 2019 Pacific National Industries, Inc. Eric Walsh walked across the tarmac toward the flight operations building for Pacific National Industries, Inc. (PNI). He had flown PNI COO Dwight Daniels and senior vice president and CFO Meredith Ackerman back from the company's newly acquired agribusiness in Memphis, Tennessee. Daniels and Ackerman had spoken briefly about the meeting next week, wherein Walsh would present the strategic outlook for the flight department. That meeting was weighing heavy on Walsh's mind. He had been promoted to director of aviation following former director Kevin McNamara's retirement. McNamara had been comfortable with the status quo, and the department now needed a major overhaul, according to the results of an outside consulting report. The Company PNI was one of the nation's largest chemical companies, producing and marketing chemicals, fabricated fibers, explosives, propellants, and agricultural products. PNI's goods were used in a broad range of industries throughout the world. With 2018 sales expected to exceed $ 20 billion, PNI was ranked among Fortune's 200 largest US corporations. . . .