cssi/SciSciGPT-SciSciNet huggingface dataset:
Antibiotic Prophylaxis in Acute Necrotizing Pancreatitis Revisited

Objective:To review studies of antibiotic prophylaxis in acute necrotizing pancreatitis published in the last decade and update recommendations.Data Sources:A search of PubMed (1998–July 2009) was conducted using the terms necrotizing pancreatitis, antibiotics, prophylaxis, and treatment. Clinical studies, meta-analyses, and review articles published in English were included. Additional references were obtained from article bibliographies. Randomized trials published before 1998 were included if indicated.Study Selection and Data Extraction:Relevant studies or meta-analyses on antibiotic prophylaxis since our previous review in 1998 were evaluated; older data were included if still relevant.Data Synthesis:Since our previous review, 4 more randomized trials, including 2 double-blind trials, have been conducted. The blinded studies found no significant difference in mortality with antibiotic prophylaxis compared with placebo, while the unblinded studies found a significant decrease in infections. Given thes...
Effects of Early Progressive Eccentric Exercise on Muscle Size and Function After Anterior Cruciate Ligament Reconstruction: A 1-Year Follow-up Study of a Randomized Clinical Trial

Background and Purpose. The authors previously reported that focused eccentric resistance training during the first 15 weeks following anterior cruciate ligament reconstruction (ACL-R) induced greater short-term increases in muscle volume, strength, and measures of function relative to standard rehabilitation. The purpose of this study was to evaluate the effects of early progressive eccentric exercise on muscle volume and function at 1 year after ACL-R. Participants and Methods. Forty patients who had undergone an ACL-R were randomly assigned to 1 of 2 groups: a group that received early progressive eccentric exercise (n20) and a group that received standard rehabilitation (n20). Seventeen participants in the eccentric exercise group and 15 participants in the standard rehabilitation group completed a 1-year follow-up. Magnetic resonance images of the thighs were acquired 1 year after ACL-R and compared with images acquired 3 weeks after surgery. Likewise, routine knee examinations, self-report assessments, and strength and functional testing were completed 1 year after surgery and compared with previous evaluations. A 2-factor analysis of variance for repeated measures (group time) was used to analyze the data. Results. Compared with the standard rehabilitation group, improvements in quadriceps femoris and gluteus maximus muscle volume in the involved lower extremity from 3 weeks to 1 year following ACL-R were significantly greater in the eccentric exercise group. Improvements in quadriceps femoris and gluteus maximus muscle volume were 23.3% (SD14.1%) and 20.6% (SD12.9%), respectively, in the eccentric exercise group and 13.4% (SD10.3%) and 11.6% (SD10.4%), respectively, in the standard rehabilitation group. Improvements in quadriceps femoris muscle strength and hopping distance also were significantly greater in the eccentric exercise group 1 year postsurgery. Discussion and Conclusions. A 12-week focused eccentric resistance training program, implemented 3 weeks after ACL-R, resulted in greater increases in quadriceps femoris and gluteus maximus muscle volume and function compared with standard rehabilitation at 1 year following ACL-R.
Statistical Software Design and Scientific Breakthrough: Some Reflections on the Future

Data analysis software has played a major role in the recent evolution of certain types of scientific disciplines which are characterized by weak theory and intercorrelated independent variables. The evolution of these fields of inquiry has depended as much upon data analysis packages for their progress as astronomy has upon the telescope, cellular biology the microscope, and particle physics the accelerator. Three new developments in the capabilities and organization of these software packages are pending or will emerge in the foreseeable future, and are discussed in terms of their potential impact on accelerated scientific discovery in the fields of inquiry that such software packages serve. They are: research-oriented graphics, true conversational analysis, and voice controlled software. These developments may help produce a revolution in scientific insight in a number of disparate fields.
Interactions about text and pictures: What can we learn from a shared reading

Abstract The purpose of this paper is to compare the discourse between an adult and children as they make meaning of and respond to text and to pictures. The subjects of the study were a mother and her two children, a 5‐year‐old boy and a 3‐year‐old girl. The interaction patterns and the content of the exchanges were investigated through qualitative and quantitative analyses. The findings revealed that a non‐directive format was used during discourse about the pictures and a question‐response format was used in conversation about the text. The adult used a greater number of verbal units per exchange and initiated the majority of the exchanges related to the text. A greater percentage of the children's utterances were information giving as opposed to information asking. Implications of the results for classroom teachers were discussed.
Whole Abdominal Wall Segmentation using Augmented Active Shape Models (AASM) with Multi-Atlas Label Fusion and Level Set

The abdominal wall is an important structure differentiating subcutaneous and visceral compartments and intimately involved with maintaining abdominal structure. Segmentation of the whole abdominal wall on routinely acquired computed tomography (CT) scans remains challenging due to variations and complexities of the wall and surrounding tissues. In this study, we propose a slice-wise augmented active shape model (AASM) approach to robustly segment both the outer and inner surfaces of the abdominal wall. Multi-atlas label fusion (MALF) and level set (LS) techniques are integrated into the traditional ASM framework. The AASM approach globally optimizes the landmark updates in the presence of complicated underlying local anatomical contexts. The proposed approach was validated on 184 axial slices of 20 CT scans. The Hausdorff distance against the manual segmentation was significantly reduced using proposed approach compared to that using ASM, MALF, and LS individually. Our segmentation of the whole abdominal wall enables the subcutaneous and visceral fat measurement, with high correlation to the measurement derived from manual segmentation. This study presents the first generic algorithm that combines ASM, MALF, and LS, and demonstrates practical application for automatically capturing visceral and subcutaneous fat volumes.
The Diagnosis and Treatment of Fibromuscular Dysplasia: An Update for Cardiologists

Fibromuscular dysplasia (FMD) is an arteriopathy of unknown etiology which has traditionally been associated with secondary hypertension; however, it has garnered increased attention in the cardiology field in the recent years because of its potential association with spontaneous coronary artery dissection. Cardiologists should be aware that FMD is a polyvascular disease which can affect any arterial bed and can result in morbid conditions such as chronic headaches, pulsatile tinnitus, stroke from cervical artery dissection, and renal infarction from renal artery dissection and has also been associated with increased prevalence of arterial aneurysm, including brain aneurysm. For these reasons, some experts recommend panvascular imaging from head-to-pelvis upon diagnosis for screening purposes and targeted imaging surveillance after diagnosis. When necessary, endovascular intervention with angioplasty alone is the preferred modality, though there are still situations which require surgical intervention. Patients with FMD may benefit from a multispecialty team approach for optimal treatment.
“I have tried to capture you …”: Rethinking the “Alma” Theme from Mahler's Sixth Symphony

Abstract Since the 1940s, Mahler9s Sixth Symphony has been transmitted with an informal “domestic” program centered on several claims first made in Alma Mahler9s Erinnerungen . In the work, she writes, Gustav meant to depict their children (in the Scherzo), himself (in the Finale), and finally her , in the first movement9s swooning secondary theme. Though critics have almost universally accepted Alma9s anecdote, few have seriously asked the important question of what such a portrait would be doing in Mahler9s most expressly tragic symphony. In this study I offer a hermeneutic perspective on the Sixth that concedes the possible truth of Alma9s anecdote but which challenges the conventional assumption that such a spousal tribute should best be understood as a one-sided testament to Mahler9s newfound nuptial bliss. After examining the theme9s reception history and Mahler9s domestic circumstances during the symphony9s composition, I explore the ways in which the first movement9s sonata narrative—a protracted conflict between (and reconciliation of) its two gendered subjects—suggestively mirrors the prevailing psychodynamics of Mahler9s strained marriage. At the end of the essay I propose how this revised hearing of the opening movement might prompt a reimagining of the entire Sixth as a projected or imagined “domestic tragedy,” with special focus on the intertextual links between the work9s outer movements and also between the cataclysmic finale and the penitentially anguished portions of the Third Symphony9s “Armer Kinder Betterlied.”
A Test of the Social Isolation of Male Tokens

The article discusses a research on social isolation of male tokens in a nursing school environment. Such study was limited to testing the social isolation of male tokens, indicating that future re...
Rapid antigenic typing of herpesvirus hominis isolates on the surface of infected cells by kinetic binding of 125I-labeled HVI antibodies.

The objective of this study was to determine whether Herpesvirus hominis -induced antigens incorporated into the surface membranes of infected cells could be typed antigenically by measuring the binding rates to specific antibodies labeled with 125I. Labeled antibodies to HVI 1 were 7-10 times more avid for cells infected with HVH 1 than for cells infected with HVH 2. Thirty coded samples of HVH isolates from oral and genital sites were typed by determining the amount of infected cell-bound 125I-labeled antibody to HVH 1 after an incubation period of 20 min. at 22 C. The samples were also typed by pock size in the chorioallantoic membrane of hen’s eggs. A frequency distribution analysis of the isolates according to 125I-labeled antibody-binding activity and source showed that the genital isolates formed one group resembling HVH 2 and a second group consisting of both oral and genital strains resembled HVH 1. There was complete agreement between the two methods as to HVH antigenic type.
Eects of Airline Strategies on Airline Operations and Infrastructure Utilization

This paper describes the results of a multi-agent simulation of the evolution of Airline Operation Center (AOC) decision-making for trans-continental route selection when demand for the routes is in excess of the available slots. The results show the emergence of hawk and dove alliances in AOC strategies. In some cases, these strategies yield improved performance and utilization of NAS resources. The implications of these results are discussed.
The activity in the anterior insulae is modulated by perceptual decision-making difficulty

Previous neuroimaging studies provide evidence for the involvement of the anterior insulae (INSs) in perceptual decision-making processes. However, how the insular cortex is involved in integration of degraded sensory information to create a conscious percept of environment and to drive our behaviors still remains a mystery. In this study, using functional magnetic resonance imaging (fMRI) and four different perceptual categorization tasks in visual and audio-visual domains, we measured blood oxygen level dependent (BOLD) signals and examined the roles of INSs in easy and difficult perceptual decision-making. We created a varying degree of degraded stimuli by manipulating the task-specific stimuli in these four experiments to examine the effects of task difficulty on insular cortex response. We hypothesized that significantly higher BOLD response would be associated with the ambiguity of the sensory information and decision-making difficulty. In all of our experimental tasks, we found the INS activity consistently increased with task difficulty and participants' behavioral performance changed with the ambiguity of the presented sensory information. These findings support the hypothesis that the anterior insulae are involved in sensory-guided, goal-directed behaviors and their activities can predict perceptual load and task difficulty.
Analysis the monitoring results of 9 360 airborne microbes of guest rooms in hotels

Objective To investigate the hygienic status of public goods and air of the hotels in Yulin city for the protection of the health of the customers,and provide scientific evidence for developing effective supervision and control measures.Methods According to GB/T 17220-1998 "Technical rules of health monitoring for public places",and GB/T 18204-2000 "Standard examination methods for public places",comprehensive survey has been made.Results From 2006 to 2010,the overall passing rate was 92.81% in Yulin's hotels,and the passing rate of each year was 87.92%,90.67%,94.52%,95.86% and 94.77%,showing a trend of increase.The passing rates of high class,middle class and low class hotels were 96.20%,91.71% and 87.97%,respectively.Of which the passing rate for the cups was the highest,95.51%,and the passing rates of the towels,bedding and indoor air were 94.43%,92.62% and 84.16%,respectively.For the 3 kinds of public goods,the total bacterial count,coliform bacteria count,and bacteria passing rate were 92.85%,99.60%,and 99.98%,respectively.Among different seasons,the passing rates in summer and autumn were lower than other seasons.The passing rates showed significant differences(P0.005).Conclusion Hygiene status of the city hotel industry was improved year by year,but still need to strengthen the health surveillance,monitoring and improving the sanitary quality of rooms,to avoid the outbreak of infectious diseases.
Epidemic analysis of kala-azar in Xinjiang Uygur Autonomous Region from 2004 to 2014

Objective To analyze epidemiological features and epidemic dynamic trend of kala-azar in Xinjiang, to provide scientific basis for monitoring and formulating prevention measure. Methods Epidemic data of kala-azar cases and surveillance information in Xinjiang from 2004 to 2014 were downloaded from National Infectious Diseases Reporting System, and statistically analyzed by using Spss 19.0 and Epi Info 3.5.3 software. Results Totally 1 588 kala-azar cases were reported during the observed period, with yearly average incidence rate of 0.686 7/100 000. The highest cumulative incidence rate(or the average incidence rate) was in Jiashi County and Kashi Region. Cases were mainly concentrated in autumn(September to November), accounting for 35.92%, with the peak in October. The cases were mainly scattered children, accounting for55.88%. The group of children under 10 years old was high-risk population, accounting for 77.58%, with infants under 2years old of the highest incidence, holding 53.09%. The incidence was more in the male than in the female with the ratio of1.47∶1. Conclusions In resent 11 years, kala-azar in Xinjiang tends to decrease generally. The effective measures to control kala-azar endemic are controlling sandfly, screening and treating patients.
The Discovery of Artemisinin and Advances in Related Research

5·23 Beijing Antimalarial Project was conducted in 1967.In collaboration with several domestic research institutes,more than 200 staff members of phytochemistry and pharmcology specialities etc.,were organized to search after the new drugs for anti-chloroquine resistant subtertian malaria.The ancient Chinese anti-malarial prescriptions were collected and reviewed.Exceeding 380 extracts were prepared from approxi-mately 200 items of herbs,their therapeutic effects were detected by the models of mouse malaria.The No.191 neutral extract obtained by ether extraction of Artemisia annua L.at 60 ℃ exhibited distinct curative ef-fects in mice and monkeys infected with malarial parasites as well as in 21 patients with subtertian and ter-tian malaria.In November of 1972,a colorless crystlline substance with relative molecular mass of 0.282 kD was isolated from No.191 extract,it was named artemisinin and identified to be a new type of sesquiterpene lactone.Since then,the capsulized pure artemisinins were used in treatment on a large scale.2006 after-wards,WHO announced an artemisinin combination therapy(ACT),with the aim at conquering artemisinin tolerance.ACT has saved more than one million of lives in 80 countries.Owing to her crucial role playing in discovery of artemisinin,Youyou Tu was conferred a 2011 annual Lasker Clinical Medical Research Award.The academic disputes in the discovery of artemisinin,how to properly evaluate the contribution of other sci-entists,and the recent exploration of its new sources except plant kingdom are briefly reported.
Implications for Design

As mentioned previously, we began building our interprofessional medical home training clinics without much structure or a road map. Since then, we have discovered how complex adaptive systems theory can help to clarify the difficulties involved and how the SHED sub-theories can bracket a portion of the clinic system for more detailed analysis. In this chapter, we hope to help others who are contemplating or are currently on this journey by sharing some of our lessons learned about designing the training clinic.
Effect of clinical pharmacists on drug prescribing in a primary-care clinic

The effect of clinical pharmacy services on prescribing patterns and drug costs for nonsteroidal anti-inflammatory drugs (NSAIDs) and salicylates in a primary-care clinic operated by a health-maintenance organization (HMO) was studied. Two pharmacists provided clinical services to a randomly selected cluster of family practice physicians in the HMO for six months. A second family practice cluster served as a control group. The pharmacists alerted prescribers to the availability of low-cost alternatives (such as ibuprofen and salicylates) and reviewed the medication profiles of patients receiving high-cost NSAIDs. Data were collected for both physician clusters for nine months before and six months after the pharmacists' intervention. Changes in the mean numbers of prescriptions for ibuprofen and piroxicam per 1000 enrollees per physician in the baseline and evaluation periods were not significantly different between the two groups. Significantly more prescriptions for salicylates were written by physicians in the intervention group than in the control group during the evaluation period. Annualized mean drug ingredient costs per enrollee and per prescription for NSAIDS and salicylates decreased during the evaluation period in both groups, but these differences were not significant. In relatively unstructured interactions with physicians and nurses, clinical pharmacists were not able to reduce the costs associated with NSAIDs but did have a modest effect on altering salicylate prescribing patterns. This clinical pharmacy program was not economically self-sustaining during the first six months of operation, since operating costs exceeded anticipated savings.
Effects of non-native Melilotus albus on pollination and reproduction in two boreal shrubs

The establishment of abundantly flowered, highly rewarding non-native plant species is expected to have strong consequences for native plants through altered pollination services, particularly in boreal forest where the flowering season is short and the pollinator pool is small. In 18 boreal forest sites, we added flowering Melilotus albus to some sites and left some sites as controls in 2 different years to test if the invasive plant influences the pollination and reproductive success of two co-flowering ericaceous species: Vaccinium vitis-idaea and Rhododendron groenlandicum. We found that M. albus increased the pollinator diversity and tended to increase visitation rates to the focal native plant species compared to control sites. Melilotus albus facilitated greater seed production per berry in V. vitis-idaea when we added 120 plants compared to when we added 40 plants or in control sites. In R. groenlandicum, increasing numbers of M. albus inflorescences lowered conspecific pollen loads and percentage of flowers pollinated; however, no differences in fruit set were detected. The number of M. albus inflorescences had greater importance in explaining R. groenlandicum pollination compared to other environmental variables such as weather and number of native flowers, and had greater importance in lower quality black spruce sites than in mixed deciduous and white spruce sites for explaining the percentage of V. vitis-idaea flowers pollinated. Our data suggest that the identity of new pollinators attracted to the invaded sites, degree of shared pollinators between invasive and native species, and variation in resource limitation among sites are likely determining factors in the reproductive responses of boreal native plants in the presence of an invasive.
Acute limb heating improves macro- and microvascular dilator function in the leg of aged humans

We demonstrate that lower limb heating acutely improves macro- and microvascular dilator function within the atherosclerotic prone vasculature of the leg in aged adults. These findings provide evid...
On the impact of local image texture parameters on search and localization in digital breast imaging

Understanding factors that influence search and localization of signals in tomographic breast imaging can allow for the development of efficient system design and image displays. Several acquisition, reconstruction and display parameters are known to influence signal (mass or microcalcification) detection. In this abstract we examine variation in relevant image texture features with respect to digital breast tomosynthesis (DBT) acquisition parameters. We shall relate the impact of these changes in detection via correlations against results obtained from human observer localization ROC (LROC) studies. Our methods included calculation and analysis of these texture features at randomly sampled ROIs in select image sets.
Novel insights into the pathophysiology and clinical aspects of diabetic nephropathy

Diabetic nephropathy (DN) is a well-described complication of diabetes mellitus and the leading cause of end stage renal disease (ESRD). Although increased albuminuria has been the gold standard for screening, data suggests that renal damage starts long before the onset of clinically apparent increases in macro and even micro-albuminuria. Clinical practice guidelines for the prevention of DN have been traditionally focused on the control of serum glucose, blood pressure and dyslipidemia, with some focus on the renin-angiotensin-aldosterone system (RAAS) as a main target for successful therapy. Recent evidence has led to a better understanding of the underlying mechanisms of the pathophysiology of this disease and suggests that various novels pathways can be targeted to delay and even prevent the progression of DN. Hence a more comprehensive therapeutic approach to therapy is on the horizon, carrying the promise for a more successful and impactful management. This review will highlight new insights into the pathophysiology, clinical aspects and future diagnostic and therapeutic modalities for DN.
Internationalization and SMEs New Product Development Capability

A number of studies have explored internationalization in SMEs, especially with the growth in the international entrepreneurship (IE) literature. However, one area that still needs attention is inn...
The Genetic Basis of Alzheimer's Disease: Findings From Genome-Wide Studies

Abstract Alzheimer's disease (AD) is the most common form of senile dementia, characterized by the presymptomatic deposition of β-amyloid plaques followed by neurofibrillary tangles. After advanced age, family history is the second strongest risk factor for AD. Rare and highly penetrant pathogenic variants in Amyloid Precursor Protein (APP), Presenilin 1 and 2 genes (PSEN1, PSEN2) cause early-onset (before age 60 years) familial form of AD. On the other hand, late-onset AD is attributed to a commonly occurring e4 allele in the gene apoliprotein E. These four genes explain 30–50% of the heritability in AD. Genome-wide association studies have revealed additional AD genetic loci; future genetic studies involving whole-exome and whole-genome sequencing will provide a more refined knowledge of the role of different functional genetic variants in the disease pathway. In this chapter we review past and current genetic studies in AD, along with functional characterizations and implications for treatment and prevention of this debilitating disease.
Nurses' Perceptions of Victims of Human Trafficking in an Urban Emergency Department: A Qualitative Study

Abstract Introduction Human trafficking is estimated to surpass the drug trade as the leading illegal industry in the world. According to a recent study, over 87.8% of trafficking survivors came into contact with a healthcare professional while they were enslaved and were not identified as a victim of human trafficking. The aims of this study are to understand the perceptions of emergency nurses about human trafficking, victims of violence, and prostitution. Methods A qualitative, descriptive study using a semi-structured interview approach was done with ten registered nurses in a large, urban Emergency Department in the northeastern U.S. Interviews were recorded and transcribed; thematic analysis was performed. Results Six themes emerged from the interviews including, "human trafficking exists in the patient population" yet no nurse has screened or treated a victim; human trafficking victims are perceived to be "young, female, and foreign born"; all of the emergency nurses reported having worked with or screened a victim of violence; victims of violence were viewed as patients who present as "sad and grieving"; prostitutes are seen as "hard and tough"; and emergency nurses did not have education on human trafficking victims' needs or resources. Discussion Emergency nurses should be more aware about victims of human trafficking. The media portrayal of human trafficking victims had influenced the nurses' perceptions of this population. Victims of violence are perceived to be very different from prostitutes, but there is a desire for education about violence as well as information about specific resources open to victims.Image 1Contribution to Emergency Nursing Practice •Emergency nurses are in a key position to identify and care for victims of human trafficking but do not have enough education regarding how to identify these victims and which resources to use for them. •Differing perceptions of emergency nurses regarding victims of violence, prostitution, and human trafficking can potentially affect the care delivered to these patients.
Does Local News Side With Local Organizations? A Case Study of Boosterism and Dependence on Local and National Sources

This case study examines how local news tends to represent a crisis of a local organization differently from national news. Based on reviewing literature on local news boosterism, this study sugges...
The Use of Serious Games and Simulations in Health Education: Raising Awareness of Depression in College-Age Students

The healthcare profession is task-and-performance-based where clinical reasoning is paramount with integrity, empathy and compassion. Many of these attributes are difficult to teach and assess in a traditional classroom. Patient safety is the ultimate outcome. Several serious game and simulation techniques have surfaced that allow the learner to enhance learning for healthcare professionals in safe environments, without compromising the patient safety, while maintaining a high degree of realism. The author discusses the multifaceted aspect of arts, social sciences and technology using the design, development evaluation and findings of a serious game/simulation technique on topic of suicide intervention/prevention.
A pilot study evaluating a peer led and professional led physical activity intervention with blue-collar employees.

OBJECTIVE: To measure the effect of a physical activity intervention, based on social cognitive theory, delivered by a peer and a professional leader. DESIGN: Quasi-experimental. SETTING: Three locations at a large Mid-Western railroad. SUBJECTS: One hundred and forty-eight skilled labor employees participated: one hundred and twenty completed the study. MEASURES: Self-reported energy expenditure, self-efficacy and stages of change. RESULTS: ANOVA and categorical analysis using rates and proportions were used for evaluation. The peer group had a non-significant short-term increase in energy expenditure of 3%, which returned to baseline post intervention. The professional and control groups showed a non-significant decrease in energy expenditure of 5% and 9%, respectively. The peer (p < 0.002) and professional groups (p < 0.004) showed significant increases in average stages scores. The peer group maintained increases over time (p < 0.001). The peer and professional led groups showed a 54% and 24% increase in the number of employees reporting regular physical activity over time, respectively. The peer group also showed positive trends in self-efficacy. CONCLUSIONS: The peer intervention enhanced self-efficacy and self-reported physical activity. A job layoff at the professional led site confounded comparisons between locations. Employees reported high energy expenditure and high BMI values, suggesting that a weight management intervention may be more appropriate and appealing in this population.
Plantain, Starchy Banana, Breadfruit, and Jackfruit

Plantains and starchy bananas are important food staples for more than 50 million people in many tropical countries. They are one of the least expensive source of caloric food to produce and are commonly available throughout the year. The compatibility of plantains for intercrop cultivation is a decided advantage for their extensive use in subsistence farming.
Effects of sustained daily latanoprost application on anterior chamber anatomy and physiology in mice

Latanoprost is a common glaucoma medication. Here, we study longitudinal effects of sustained latanoprost treatment on intraocular pressure (IOP) in C57BL/6J mice, as well as two potential side-effects, changes in iris pigmentation and central corneal thickness (CCT). Male C57BL/6J mice were treated daily for 16 weeks with latanoprost. Control mice were treated on the same schedule with the preservative used with latanoprost, benzalkonium chloride (BAK), or handled, without ocular treatments. IOP and CCT were studied at pre-treatment, 2 "early" time points, and 2 "late" time points; slit-lamp analysis performed at a late time point; and expression of corneal and iridial candidate genes analyzed at the end of the experiment. Latanoprost lowered IOP short, but not long-term. Sustained application of BAK consistently resulted in significant corneal thinning, whereas sustained treatment with latanoprost resulted in smaller and less consistent changes. Neither treatment affected iris pigmentation, corneal matrix metalloprotease expression or iridial pigment-related genes expression. In summary, latanoprost initially lowered IOP in C57BL/6J mice, but became less effective with sustained treatment, likely due to physiological adaptation. These results identify a new resource for studying changes in responsiveness associated with long-term treatment with latanoprost and highlight detrimental effects of commonly used preservative BAK.
Genetic diversity of tumors with mismatch repair deficiency influences anti–PD-1 immunotherapy response

Tumors with mismatch repair deficiency (MMR-d) are characterized by sequence alterations in microsatellites and can accumulate thousands of mutations. This high mutational burden renders tumors immunogenic and sensitive to programmed cell death–1 (PD-1) immune checkpoint inhibitors. Yet, despite their tumor immunogenicity, patients with MMR-deficient tumors experience highly variable responses, and roughly half are refractory to treatment. We present experimental and clinical evidence showing that the degree of microsatellite instability (MSI) and resultant mutational load, in part, underlies the variable response to PD-1 blockade immunotherapy in MMR-d human and mouse tumors. The extent of response is particularly associated with the accumulation of insertion-deletion (indel) mutational load. This study provides a rationale for the genome-wide characterization of MSI intensity and mutational load to better profile responses to anti–PD-1 immunotherapy across MMR-deficient human cancers.
Quantitative evaluation of the thallium binding of soluble and insoluble Prussian blue hexacyanoferrate analogs: A scientific comparison based on their critical quality attributes.

Abstract There has been a long-standing discussion in the scientific literature on the thallium (Tl) binding capacity of ferric hexacyanoferrate (insoluble) and potassium hexacyanoferrate (soluble) forms of Prussian blue (PB). The literature sometime suggests that the soluble form of PB should be used to treat thallium poisoning, instead of the FDA approved insoluble form of PB. The literature debate is further complicated by the lack of fundamental characterization data such as critical quality attributes (CQAs) that clearly define the analog forms. The purpose of this study is to compare, the binding capacity of soluble and insoluble PB analogs with the same CQAs (particle size/distribution and water content). Water content and particle size/particle distribution were determined by TGA, and solid-state laser diffraction particle sizing. Thallium binding studies were conducted at physiological pH to determine the maximal binding capacity (MBC) at equilibrium. Multiple linear regression and principal component analysis was also used for multivariate data analysis. Results indicate that insoluble and soluble analogs, with similar quality attributes, have nearly identical, MBC binding capacities of (441.5 mg/g) for insoluble vs soluble (458.4 mg/g). However, when both analog forms with different CQAs such as water, particle size were compared, results indicated significantly higher or lower thallium binding levels. In conclusion, it is essential that the FDA approved iron form with well-defined CQAs is used to treat thallium poisoning and radioactive thallium metal contamination for consistent therapeutic outcomes.
Occupational therapy for adults with brain tumors in the acute care setting

The number of adults diagnosed with brain tumors is increasing, as are the survival rates. Neurological impairments from brain tumors can impact activity and participation. Adults with brain tumors benefit from post-acute rehabilitation. However, there is limited evidence from the acute care setting. The purpose of this study was to examine how acute care occupational therapy services were utilized and whether patients made functional gains after receiving occupational therapy services. A retrospective chart review of 153 electronic medical records was completed for patients who received occupational therapy services at a large teaching hospital. Data collected included number of occupational therapy visits, the types of interventions, and patient performance using the Boston University Activity Measure for Post-Acute Care "6 Clicks for Daily Activity" short form (AM-PAC). More than half the patients received one occupational therapy visit (54.2%) with a median length of stay of three days. Most interventions focused on activities of daily living (ADLs). Of those patients who received more than one visit, 67% showed improvements in their AM-PAC scores. Occupational therapy practitioners provided interventions that addressed ADLs, and patients demonstrated gains in functional performance. These findings suggest that patients benefit from occupational therapy services provided in the acute care setting.
Net-zero energy building design and life-cycle cost analysis with air-source variable refrigerant flow and distributed photovoltaic systems

Abstract Net-zero energy building (NZEB) design has been gaining widespread acceptance as a major driver to reach feasible long-term goals of energy reductions in a building sector for the coming decades. Accordingly, net-zero energy targets for commercial buildings have been specified by federal and/or local government agencies in U.S. Although moving toward NZEB goals has technically feasible long-term advantages, economic issues are one of primarily concerns by building owners and designers for the application of advanced building technologies in NZEB design of their retrofit or new building construction. However, the lack of life cycle cost (LCC) data has still hindered reliable understanding of adopting NZEB design by building owners in a cost-effective manner. In response to this gap, this study conducts life-cycle cost analysis (LCCA) of NZEB design with an energy-efficient heating, ventilation, and air conditioning (HVAC) system and a solar power generation system. To enable NZEB design, an air-source VRF heat pump (HP) type system is considered for energy-efficient HVAC equipment in an office building model with a grid-tied photovoltaic (PV) system. Results reveal that the LCC of NZEBs varies primarily due to a combined effect of annual site EUIs, on-site power generation, and cost-items of each location in U.S. climates. Some hot and mild climate zones in the U.S. represent that LCC values of NZEBs are considerably lower. In contrast, some other cold zones result in unattractive LCC values for NZEBs, caused by a combined effect of relatively lower potential of on-site PV electricity generation and city cost indices. Yet, with subsidized financing by the federal government for PV installation costs, LCC values of NZEBs become significantly attractive in most climate locations.
The impact of a post-operative clinical care pathway on head and neck microvascular free tissue transfer outcomes.

Objective To study the impact of a clinical care pathway and computerised order set on short-term post-operative outcomes for patients undergoing head and neck free tissue transfer. Methods In this retrospective cohort study, patients who underwent head and neck free tissue transfer by a single reconstructive surgeon between January 2007 and July 2009 were assigned to one of two cohorts based on the timing of their surgery: pre- or post-clinical care pathway implementation. Measured outcomes included peri-operative complications and mortality, length of hospital stay and costs, unplanned reoperations, and readmissions within 30 days of discharge. Results The pre-clinical care pathway cohort included 81 patients and the post-clinical care pathway cohort comprised 46. Implementation of the clinical care pathway was associated with decreased variability in length of hospital stay (median (interquartile range) = 8 (6, 11) vs 7 (6, 9) days). The post-clinical care pathway cohort also had a significantly lower unplanned reoperation rate (15.2 vs 35.8 per cent, p = 0.01). Conclusion A clinical care pathway is a successful means of standardising and improving complex patient care. In this study, care pathway implementation in head and neck free tissue transfer patients improved efficiency and the quality of patient care.
A multimodal assessment of tobacco use on a university campus and support for adopting a comprehensive tobacco-free policy.

Abstract Many college campuses now prohibit tobacco use. At a private U.S. university, the current study assessed cigarette and e-cigarette use and characterized the climate for adopting a comprehensive tobacco-free policy. Data were gathered January–August 2018 via an: environmental scan; cigarette-urn audit; and representative surveys with campus community members. Despite low prevalence of tobacco (0.5%–8%) and e-cigarette use (0.9%–6%) among all groups, campus cigarette clean-up costs exceeded $114,000 for an estimated >1 million butts left on campus annually. A majority of respondents (63% of N = 2218) favored a campus-wide tobacco-free policy, 16% opposed, and 21% abstained. Most respondents endorsed benefits of supporting health (93%), ensuring tobacco-free air to breathe (92%), reducing litter (88%), preventing tobacco use (84%) and fires (83%), and helping tobacco users quit (65%). Identified challenges included policy enforcement (69%) and stigmatization of smoking (57%); 30% viewed a policy as compromising personal freedoms. In a model explaining 35% of variance in policy support, those more likely to favor comprehensive tobacco-free campus policy were Asian respondents; diagnosed with asthma; exposed to secondhand smoke on campus; who viewed campus cigarette butt litter as problematic; and identified health, prevention, and cessation benefits of a tobacco-free campus. Those less likely in favor were students, those who smoke, and those perceiving impingement upon personal freedoms, stigmatization, and broader (slippery slope) implications. Findings indicate low tobacco use prevalence among the campus community, yet a large volume of butt litter and high tobacco clean-up costs. Predictors of policy support can inform campus outreach efforts.
An Overview of the Regulation Best Interest Rule Package

On June 5, 2019, the SEC adopted the Regulation Best Interest Rule Package. The package consists of (i) Regulation Best Interest: The Broker-Dealer Standard of Conduct; (ii) Form CRS Relationship Summary and Amendments to Form ADV; (iii) the SEC Interpretation Regarding Standard of Conduct for Investment Advisers; and (iv) the SEC Interpretation Regarding the “Solely Incidental” Prong of the Broker-Dealer Exclusion from the Definition of Investment Adviser. Additionally, FINRA (the Financial Industry Regulatory Authority) has amended several of its rules following the SEC’s adoption of Reg. BI. This article describes Reg. BI and Form CRS, as well as the additional SEC guidance and FINRA rules changes.
Quantum plasmons and intraband excitons in doped nanoparticles: Insights from quantum chemistry

We use excited-state quantum chemistry techniques to investigate the intraband absorption of doped semiconductor nanoparticles as a function of doping density, nanoparticle radius, and material properties. Modeling the excess electrons as interacting electrons confined to a sphere, we find that the excitation evolves from single-particle to plasmonic with increasing number of electrons at fixed density, and the threshold number of electrons to produce a plasmon increases with density due to quantum confinement and electron–hole attraction. In addition, the excitation passes through an intermediate regime where it is best characterized as an intraband exciton. We compare equation-of-motion coupled-cluster theory with those of more affordable single-excitation theories and identify the inclusion of electron–hole interactions as essential to describing the evolution of the excitation. Despite the simplicity of our model, the results are in reasonable agreement with the experimental spectra of doped ZnO nanoparticles at a doping density of 1.4 × 1020 cm−3. Based on our quantum chemistry calculations, we develop a schematic model that captures the dependence of the excitation energy on nanoparticle radius and electron density.
The Association of State Firearm Legislation With the Burden of Firearm-Related Surgery.

Abstract Background United States state-level firearm legislation is linked to rates of firearm-related suicides, pediatric injuries, nonfatal injuries, hospital discharges, and mortality. Our objective was to evaluate the burden of firearm-related injuries requiring surgery for states with strict as opposed to nonstrict firearm legislation. Materials and methods The 2014 Healthcare Cost and Utilization Project State Inpatient Database was utilized to extract data for all available 28 states and the District of Columbia. States were dichotomized into strict and nonstrict legislative categories using the 2014 Brady and Gifford's scores (15 strict, 14 nonstrict). Patients with a firearm injury requiring surgery were identified and the incidence of surgery aggregated to the county level. Negative binomial regression with an offset for county-level residential population was used to estimate the incident rate ratio for surgical volume comparing counties in strict and nonstrict states. Models were stratified by injury intent and adjusted for county population characteristics. Results A total of 11,939 patients were hospitalized with firearm-related injuries, with 65% (n = 7759) undergoing an operative procedure. The adjusted incidence rate of firearm-related surgery per 100,000 people was 1.29 (95% confidence interval; 1.13-1.46, P Conclusions The rate of firearm-related surgical intervention was higher for states with nonstrict firearm legislation than that for states with strict legislation. States should reevaluate their firearm legislation to potentially reduce the burden of firearm-related surgery and health care costs.
Affective Polarization and Support for the U.S. Supreme Court

Support for the U.S. Supreme Court does not appear to be polarized on ideological or partisan lines. However, the form of polarization for which the mass political behavior field has amassed substa...
Improving Documentation Using a Real-Time Location System in a Pediatric Emergency Department

Background Appropriate documentation of critical care services, including key time-based parameters, is critical to accurate severity of illness metrics and proper reimbursement. Documentation of time-based elements for critical care services performed in emergency departments (ED) remains inconsistent. We integrated electronic medical record and real-time location system (RTLS)-derived data to augment quality improvement methodology. Objective We aimed to increase the proportion of patient encounters with critical care services performed at a pediatric ED that had appropriate documentation from a baseline of 76 to 90% within 6 weeks. Methods The team formulated a framework of improvement and performed multiple plan-do-study-act cycles focused on key drivers. We integrated the capabilities of an RTLS for precise location tracking to identify patient encounters in which critical care services were performed and to minimize unnecessary audits and feedback. We developed an intervention using iterative revisions to address key drivers and improve documentation. The primary outcome was the proportion of patient encounters for which critical care services were performed for which a time-based attestation was documented in the medical record. Results We analyzed 92 encounters between March 2020 and April 2020. While the proportion of eligible patient encounters with critical care documentation improved from 76 to 85%, this change was unable to be directly attributed to improvement efforts. Patients with respiratory complaints encompassed the majority of eligible encounters without appropriate documentation. Conclusion Utilizing improvement methodology and a novel application of RTLS, we successfully identified the co-location of physicians with patients receiving critical care services and designed interventions to improve documentation of critical care services provided in a pediatric ED. While changes were not able to be attributed to improvement efforts in this project, this project demonstrates the utility of RTLS to augment and inform systematic improvement efforts.
Impact of cancer on the risk of unplanned 30-day readmissions.

6581Background: Hospital readmission are associated with unfavorable patient outcomes and increased costs to the healthcare system. Devising interventions to reduce risks of readmission requires un...
Pathology Informatics and Robotics Strategies for Improving Efficiency of COVID-19 Pooled Testing

The global rise of the coronavirus disease 2019 pandemic resulted in an exponentially increasing demand for severe acute respiratory syndrome coronavirus 2 testing, which resulted in shortage of re...