cssi/SciSciGPT-SciSciNet huggingface dataset:
Streams and Rivers as Ecosystems

Over the last half century, stream ecologists have developed and nurtured an effective ecosystem approach to the study of streams. Streams are elongate ecosystems with a high degree of connectivity with adjacent ecosystems such as terrestrial forests. Small headwater streams are highly dependent on energy input from the forest in the form of organic detritus. In temperate North American streams, this material enters as autumn-shed tree leaves, which are rapidly colonized by fungi and bacteria and are consumed by a sequence of detritivores distinguished by how they use this allochthonous material, i.e., their functional group. In situ photosynthesis is low in heavily shaded small streams but increases in a downstream direction as the channel widens and sunlight reaching the stream surface increases. At any one point in the river continuum, organic matter becomes available as imported organic matter or via in situ photosynthesis. Energy outputs occur by biological respiration and export. Transport from one reach to another can be an important organizing force, generating an ecosystem that is spatially oriented and continuously changing in space. The stream ecosystem consists of several vertically and laterally arranged interacting elements – the surface stream, the hyporheic, parafluvial, and riparian zones, and the floodplain. Water and transported particulate and dissolved materials move among the components of this complex landscape via a network of interacting flowpaths. Increasingly, stream ecologists are acknowledging the role of spatial heterogeneity in stream ecosystem functioning and are adopting the concepts and techniques of landscape ecology to understand the stream ecosystem. Embracing stream ecosystems as branched instead of linear structures is one of the most promising conceptual advances in the field.
Rapa Nui National Park, Easter Island, Chile: An Eco-Tourism Outline with Issues and Suggestions

The goal of this suggested eco-tourism plan for Rapa Nui National Park in Chile is to guide the development of an environmentally sensitive plan to carry the park, a World Heritage site, into the future. A plan developed from an expanded version of this plan will guide the use and development of this world heritage site while simultaneously preserving and protecting and, where possible, enhancing the park resources. It must also take into account the three thousand residents of Easter Island, especially the indigenous Rapa Nui who have taken care of these resources for centuries and depend on them for spiritual and economic well being.
Computational Complexity and New Computing Approaches

Computational complexity analysis allows us to quantify energy-efficiency scaling potential--an important task for assessing research options.
Implementation of a β-Agonist/Airway Clearance Protocol in a Pediatric ICU.

BACKGROUND: Respiratory therapist (RT)-driven protocols have been in use for over 30 years. Protocols have been reported to decrease unnecessary or harmful therapy, health-care costs, and hospital stay. This study represents the evaluation of an original respiratory care protocol in the pediatric ICU at Arkansas Children9s Hospital for β-agonist and airway clearance interventions where one did not exist. METHODS: This project was composed of 2 parts: a survey administered to RTs and licensed independent practitioners and a retrospective review of outcome data comparing a therapist-driven β-agonist/airway clearance protocol with physician-directed respiratory care ordering in a patient population admitted for acute respiratory failure. RESULTS: Acceptance of the protocol was evident in the survey responses because overall perceptions surrounding the implementation of the β-agonist/airway clearance protocol were positive, and responders perceived that the protocol implementation elevated the status and increased the value of respiratory therapists. For the comparison of physician-directed orders with therapist-driven protocols, there were no significant differences between pre- and post-intervention groups for mean age, sex, mean daily acuity, or mean weighted daily acuity (P = .33, .19, >.99, and .79, respectively). There were also no differences in pediatric index of mortality 2, pediatric index of mortality 2 rate of mortality, pediatric risk of mortality 3 probability of death, and pediatric risk of mortality 3 scores (P = .63, .56, .19, and .44, respectively) between the 2 groups. When comparing physician-directed orders to therapist-driven protocols, all outcome measures (length of stay, β-agonist therapies, airway clearance therapies, and ventilator days) showed statistically and clinically important reductions, adjusting for subject characteristics (P CONCLUSIONS: In this institution, implementation of a β-agonist/airway clearance protocol resulted in significant reductions of subject interventions and improved outcomes by decreasing length of stay and ventilator days as well as contributing information where clinical evidence is scant, specifically the pediatric ICU.
Comparison of the Infrared Absorptivities of some Prussian Blue Analogues and their use to Determine the Composition of Core-Shell Particles

Abstract A library of relative absorptivities of the C-N stretching modes for a series of Prussian blue analogues (PBAs), AxMy[M′(CN)6]z·nH2O (A = alkali cation; M, M′ = transition metals), has been assembled based on analysis of Fourier transform infrared (FTIR) spectra. Chemical variables including transition metal identity, cation identity, stoichiometry, and oxidation state have been considered. The absorptivities for individual PBAs were then applied to determine the composition of core–shell particles with varying shell thickness and the results correlate well with analyses derived from energy dispersive X-ray spectroscopy (EDS). Knowledge of relative absorptivities allows generally accessible FTIR methods to contribute to quantitative characterization of multiple phase Prussian blue analogue samples and PBA heterostructures.
Trading utilization for circuitry: Hardware-software co-design for real-time software-based short-circuit protection

Short-circuit faults are a potential source of damage to circuitry in DC-powered systems. Industrial applications including power converters, inverters, and insulated-gate bipolar transistors (IGBTs) often rely on fault detection systems in the form of dedicated circuitry to prevent damage. To increase flexibility in short-circuit detection and decrease dedicated circuitry, a software-based approach is presented. This implementation requires minimal circuitry and allows for tradeoff between board space and processor utilization. The design relies on a single inductor and microprocessor running a real-time task for identifying current and monitoring circuitry for faults. Experiments demonstrate detection of both hard-switching faults (HSF) and fault under load (FUL) shorts. The depicted relationship between processor utilization and board space consumed by the circuitry is confirmed through experimentation and allows optimization of board space with respect to utilization and vice versa. As a result, the proposed software-based detection is implementable with the addition of a single component and protects against damage from both HSF and FUL shorts.
A Self-Protection Agent Using Error Correcting Output Codes to Secure Computers and Applications

The human immune system is incredibly efficient at identifying self- and non-self entities in our bodies. A non-self entity (malicious), once identified, is attacked by particular types of cells to remove the intruder before it can cause damage. Our immune system has components that identify not only non-self entities but also recall old entities that may not have been encountered for a very long time, but it is still essential that these entities be correctly classified as malicious. The domain of cybersecurity can significantly benefit from having a framework that can identify, react and adapt to malicious behaviors. Such a model for cyber protection should draw a parallel to our immune system, at least at a high level. In this work, we present a flexible framework that leverages machine learning to identify malicious behaviors that are threats to users, computers, and applications in a network. The proposed framework relies on the collection and aggregation of information relevant to identifying such malicious behaviors, machine learning — to learn and identify non-self behaviors automatically, and an adaptation mechanism to incorporate new threats for future classification. We benchmarked the proposed approach on a data set collected from multiple users, computer and applications, and we show that attacks (i.e., non-self behaviors) can be identified and mitigated through software. We compared classification models that perform binary classification (i.e., self or non-self), as well as multi-class predictions (i.e., what type of non-self behavior is detected).
Brownian Motion: Local Distributions

This opaque title means “distributions related to local sample path properties of Brownian motion”. I have in mind properties such as Levy’s estimate of the modulus of continuity, the corresponding results on small increments, the paradoxical fact that Brownian motion has local maxima but not points of increase, and self-intersection properties in d dimensions. Although these are “0–1” results, they can be regarded as consequences of stronger “distributional” assertions which can easily be derived via our heuristic. The topics of this section are more theoretical than were previous topics, though many are equivalent to more practical-looking problems on boundary-crossing.
A path model linking health literacy, medication self-efficacy, medication adherence, and glycemic control.

Abstract Objective To investigate whether medication self-efficacy moderates or mediates the relationship between health literacy and medication adherence. To propose a path model that illustrates the interrelated relationship between health literacy, medication self-efficacy, medication adherence, and hemoglobin A1c (HbA1c). Methods This cross-sectional study was performed via a face-to-face survey. Factors that may influence medication adherence and HbA1c were identified from the literature review. One hundred and seventy-four participants included were ≥20 years old with diagnosed type 2 diabetes, understood English, and were prescribed at least one oral diabetes medicine. During clinic visits, a questionnaire was administered to evaluate health literacy, medication self-efficacy, and medication adherence. HbA1c values were obtained from electronic medical records. Path analyses were conducted for data analysis. Results Medication self-efficacy mediated but did not moderate the relationship between numeracy and diabetes medication adherence. Participants with higher numeracy skills may develop a greater level of medication self-efficacy, which in turn may result in a higher level of diabetes medication adherence and a lower level of HbA1c. Conclusion Enhancing patients’ medication self-efficacy and numeracy skills may be imperative in intervention programs to improve diabetes medication adherence. Practice implications An improvement in numeracy skills and medication self-efficacy is recommended to enhance diabetes medication adherence.
Feasting with Foam: Ceremonial Drinks of Cacao, Maize, and Pataxte Cacao

Five hundred years ago, Spanish cleric Diego de Landa recorded that his Maya informants enjoyed foamy beverages of cacao and maize for major celebrations. Landa (1941[1566]:90) remarked on the high value the Maya placed on the buttery foam crowning these beverages. His words elicit two questions that will be considered in this analysis: How could stable foam be created on a beverage of maize gruel (atole) and chocolate, and why was the foam so highly valued? My fieldwork in the Yucatan, Tabasco, and Oaxaca provided some answers, as did replication experiments in my California kitchen using ingredients gathered while in the field. The work of previous investigators was also invaluable. But local people like Don Isaac Vasquez and his family in Oaxaca expressed a strong interest in preserving significant indigenous customs in danger of disappearance and these ethnographic sources were most important. The Canul family in Xocen, Yucatan, was equally committed to providing insight, especially Fatimo Canul Noh and his mother, Dona Jacinta Noh Pech. Not to be underestimated were the personal culinary demonstrations and help given to me by women and men whose names appear in the acknowledgments.
Practical Gas Kinetic Models and Macroscopic Properties

A low pressure gas (≤ 1 atmosphere) can be modeled using Maxwell-Boltzmann kinetics with deviations of less than a few percent from experimental data for most properties. The gas model assumes that: a) The gas is composed of rigid spheres that have vanishingly small volumes. b) There are no long range interactions between spheres. c) All gas-gas collisions are elastic. d) The spheres have no rotational or vibrational energy.
Centralized Control of Air Conditioning: Réglage central du conditionnement d'air

Au cours des quelques dernieres annees, l'utilisation de centres de reglage faisant partie integrante des grands immeubles climatises s'est repandue rapidement. Les ingenieurs charges de la conception de petits immeubles, tels que les ecoles et les clubs, ainsi que des grands blocs de bâtiments, tels que les aeroports et les universites, trouvent aussi que les centres de reglage sont utiles dans ces constructions.
The Continuous Settlement Region

In Norway the Continuous Settlement Region is a southern coastal strip (Fig. 1). On the west coast it is about 40 km. (25 mi.) wide but near the mouth of the Oslo Fjord it doubles in width. The region includes most of Norway’s oldest settled areas and there are large sections of close permanently occupied residences in many directions. From Stavanger northward they are broken by the fjords but eastward they generally are uninterrupted excepting near the Swedish border (Fig. 2).
Intrusion detection: network security beyond the firewall

BEFORE INTRUSION DETECTION: TRADITIONAL COMPUTER SECURITY. Intrusion Detection and the Classic Security Model. The Role of Identification and Authentication in Your Environment. The Role of Access Control in Your Environment. Traditional Network Security Approaches. INTRUSION DETECTION: BEYOND TRADITIONAL SECURITY. Intrusion Detection and Why You Need It. Detecting Intruders on Your System Is Fun and Easy. Vulnerability Scanners. UNIX System-Level IDSs. Sniffing for Intruders. Intrusion Detection for NT. ROUNDING OUT YOUR ENVIRONMENT. You've Been Hit!. Intrusion Detection: Not the Last Chapter When It Comes To Security. Appendix. References. Index.
Abstract C62: Sub-Saharan African immigrant men's knowledge and support related to cervical cancer screening: A qualitative descriptive study

Background: Cervical cancer screening disparity puts sub-Saharan African immigrant women at an increased risk for development of invasive cervical cancer. Several studies have identified various factors influencing cervical cancer screening use among sub-Saharan African immigrants in the United States. One of such factors is the role of spousal support; African men are often the gatekeepers of health for their families and have significant influence on the health-seeking behavior of their wives/female partners. However, limited research exists on men9s knowledge and support related to Pap screening. Thus, we conducted a qualitative descriptive study to assess knowledge and support related to Pap screening among sub-Saharan African immigrant men in Lexington, Kentucky. Method: In-depth individual interviews using semistructured guide were conducted with 21 sub-Saharan African immigrant men who were married or in committed relationships. Data were audio recorded, transcribed verbatim, and analyzed using content analysis. Results: The average age of the study participants was 36 ± 9; 53% have lived in the US for more than 5 years; 88% were college educated; 43% make more than $50,000 annually; and 62% were married. General knowledge of Pap screening, cervical cancer, and HPV9s role in the etiology of cervical cancer was minimal. Men showed the desire to support their wives/female partners to have a Pap screening. All participants preferred to be carried along and informed about their wives9 decision to have a Pap screening in order to provide any support that might be needed. The narratives related to health care providers9 gender preference varied among men; several men showed preference for a female health care provider for Pap screening services for their wives/female partners while others showed no preference. Conclusions: These findings underscore the importance of men9s support in promoting Pap screening among sub-Saharan African immigrant women. Men should be included in cervical cancer prevention efforts to leverage their support. Thorough understanding of African family dynamics, cultural norms, and values related to preventive health care seeking is essential to the design and implementation of interventions for improving Pap screening among sub-Saharan African immigrant women. Citation Format: Adebola Adegboyega, Jennifer Hatcher. Sub-Saharan African immigrant men9s knowledge and support related to cervical cancer screening: A qualitative descriptive study [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C62.
Exploring an Ambiguous Technique for Eyes-Free Mobile Text Entry

Mobile text entry has become an increasingly important part of many peoples' daily lives. While most input occurs through individual letters being tapped on a virtual QWERTY keyboard, this does not have to be the case. We explore how well users are able to learn an ambiguous keyboard that is modeled after a standard QWERTY layout but does not require users to tap specific keys. We show that this keyboard is a plausible text entry technique for users with little or no vision, with users achieving 19.09 Words per Minute (WPM) and 2.08% Character Error Rate after 8 hours of practice.
Loneliness as a mediator for college students' social skills and experiences of depression and anxiety.

Abstract Introduction Rates of anxiety and depression are increasing among college undergraduates. Existing research has demonstrated a link between social skills and mental health outcomes. This study explores the relationship between verbal social skills (encoding and decoding) and anxiety and depression by measuring the extent to which loneliness mediates these relationships. Methods Baseline data from a cross-sequential study exploring college student mental health was used to analyze social skills, loneliness, as well as, depression and anxiety. A diverse group of students (n = 2,054; M = 19.95; SD = 1.26) participated from two residential colleges in the United States. Results Six mediation models were estimated, separately testing whether loneliness mediated the relationship between anxiety and depression and social expressiveness, sensitivity, and control. All six found that (a) anxiety and depression were separately predicted by the verbal encoding skills of social expressivity and social control and the decoding skill of social sensitivity, and (b) all of those relationships were mediated by loneliness. These models accounted for 37–38% of the variability in scores of depression and 17–20% of the variability in scores of anxiety. Conclusions The results of this study indicate verbal social skills play an important role in students experience of loneliness as well as depression and anxiety. Improving the social skills of students should be considered by colleges seeking to reduce the mental health burdens experienced by their students.
In utero Exposure to Anesthetics Alters Neuronal Migration Pattern in Developing Cerebral Cortex and Causes Postnatal Behavioral Deficits in Rats

During fetal development, cerebral cortical neurons are generated in the proliferative zone along the ventricles and then migrate to their final positions. To examine the impact of in utero exposure to anesthetics on neuronal migration, we injected pregnant rats with bromodeoxyuridine to label fetal neurons generated at embryonic Day (E) 17 and then randomized these rats to 9 different groups receiving 3 different means of anesthesia (oxygen/control, propofol, isoflurane) for 3 exposure durations (20, 50, 120 min). Histological analysis of brains from 54 pups revealed that significant number of neurons in anesthetized animals failed to acquire their correct cortical position and remained dispersed within inappropriate cortical layers and/or adjacent white matter. Behavioral testing of 86 littermates pointed to abnormalities that correspond to the aberrations in the brain areas that are specifically developing during the E17. In the second set of experiments, fetal brains exposed to isoflurane at E16 had diminished expression of the reelin and glutamic acid decarboxylase 67, proteins critical for neuronal migration. Together, these results call for cautious use of anesthetics during the neuronal migration period in pregnancy and more comprehensive investigation of neurodevelopmental consequences for the fetus and possible consequences later in life.
Assessment of the Development of Social and Learning Networks in Construction Management Courses Using Social Network Analysis

Preparing Construction Management (CM) students for their professional lives must include not only training on technical skills, but also a variety of personal interaction skills, from working with...
Meningitis and complications

Meningitis is inflammation of the pia mater, arachnoid and subarachnoid space. Meningitis is caused by infection, by bacteria or viruses. The most common cause of meningitis is viral infection that usually resolves without treatment. Bacterial meningitis is an extremely serious illness which may affect children of any age, but the most susceptible are infants under one month of age and immunosuppressed children. Children who have had bacterial meningitis have a one in four chance of being left with a permanent disability such as deafness, blindness, cerebral palsy, seizures, hydrocephalus or cognitive impairment. The signs and symptoms of meningitis in babies and young children include fever, vomiting, irritability, drowsiness, skin rash and headache. Meningitis is sometimes difficult to diagnose and requires laboratory analysis of cerebrospinal fluid. The role of ultrasound in infants with meningitis is to evaluate for complications. In the early stages of bacterial meningitis the ultrasound findings are usually normal. However as the disease progresses there may be sonographic findings such as echogenic sulci or parenchyma, ventriculitis, ventriculomegaly, venous thrombosis, infarction and abscess formation. Subdural effusions may also be present over the frontal and parietal convexities. Late sequelae include hydrocephalus, brain atrophy and cystic encephalomalacia.
Cellular manufacturing design and replenishment strategy in a capacitated supply chain system: A simulation-based analysis

Abstract This paper studies the integration of design and control phases in a three-echelon supply chain system of a blood sugar strip manufacturer. The first step is manufacturing system design based on layered Cellular Manufacturing System (CMS) for which a mixed-integer linear programming approach is proposed in order to minimize the required number of cells. The novelty of the proposed model is in incorporating shifts into layered CMS design. In the second step of the design phase inventory parameters in different levels of the supply chain are estimated based on the continuous review, fixed order quantity (Q,r) model. Control phase is triggered by releasing customer order for multiple types of products and includes replenishments in the three echelons of the supply chain and scheduling in the layered CMS. In order to evaluate the system cost, the capacitated supply chain system is simulated in Simio software package. In the first phase of the simulation, cost components are obtained based on the inventory parameters estimated in the design phase. Next, simulation based on OptQuest feature is performed to improve total cost and estimate the inventory parameters and expected cell utilization. Comparing system cost and the parameters from the design phase to the results of the OptQuest approach evaluates the manufacturing system design and the replenishment policy proposed in the design phase. Sensitivity analysis is performed to analyze the effect of shortage penalty and inventory carrying rate on the total cost of the system. Finally, statistical analysis result indicate Re-Order Point (ROP) values obtained by the OptQuest have significantly changed compared with ROP values estimated in the design phase; however, the same conclusion is not applicable for order quantity values.
Effects of Solar Radio Emissions on Outdoor Radio Propagation at 38 GHz Bands for D2D Communications

This letter presents empirical data documenting the effects of solar radio emissions on outdoor radio propagation at 38 GHz millimeter-wave (mmWave) band for both line-of-sight (LOS) and non-line-of-sight (NLOS) scenarios. Comparing the measurement data collected during a sunny day with the counterpart data collected at night, higher path loss exponent (PLE) values were observed during the day compared to nighttime. This is attributable to the decrease in the carrier-to-noise ratio for day-time signal propagation in sunny sky compared to nighttime. About 4% and 25% increase in PLE values was observed during the day for LOS and NLOS scenarios, respectively. This translates into corresponding decrease in the radio coverage of the wireless transmitter during the day compared to nighttime. Time-domain waveforms were also examined, and it was found that the average received signal envelope was 103 times below a given threshold during the day, and 19 times below the same threshold at night. This, thus, shows that the received signal envelope fades out many more times during the day compared to nighttime.
Real-world evaluation of effectiveness and tolerance of chemotherapy for early-stage breast cancer in older women.

Older patients with early-stage breast cancer (ESBC) tend to receive less aggressive treatment, have higher mortality rates, and are underrepresented in clinical trials. Outcomes, tolerance and toxicity of chemotherapy are underreported. Thus, we assessed the outcomes of chemotherapy in the real-world in a community oncology setting. We retrospectively chart reviewed consecutive older patients (≥ 70 years) with ESBC diagnosed between January 1, 2010, and December 31, 2016, who received chemotherapy at our institution. Study outcomes were survival estimates. Logistic regression determined associations with measures of intolerance. Of 1296 patients, 229 received chemotherapy. Overall, 24% had early chemotherapy cessation; 18% had dose reductions; and 27% had dose delays. Severe, life threatening and lethal toxicities occurred in 38%, 1.3%, and 2.2%, respectively; constitutional toxicity (37%) was the most common. The 1- and 3-year overall survivals were 94% and 79%; 1- and 3-year breast-specific survivals were 96% and 89%, while 1- and 3-year disease-free survivals were 95% and 82%, respectively. Anthracyclines were the most poorly tolerated regimen having associations with hospital visits (OR 10.97, 95% CI 2.10–57.23) and severe toxicities (OR 5.28, 95% CI 1.27–21.89). Anti-HER2 therapies (OR 3.03, 95% CI 1.18–7.78) and poorer performance status (PS) (OR 7.48, 95% CI 1.75–31.98) were associated with severe toxicities. Older age (> 80 years) was associated with early cessation of therapy (OR 3.64, 95% CI 1.34–9.83). Chemotherapy can be effectively delivered to older patients with ESBC and is reasonably well tolerated. The high rate of anthracycline intolerability, poorer PS, and advanced age should be considered when tailoring treatment regimens.
Remote sensing for early, detailed, and accurate detection of forest disturbance and decline for protection of biodiversity

Many ecosystems and the biodiversity they contain are currently faced with increasing disturbance frequency and intensity, concurrent with converging stress agents such as climate change, invasive species, and pollutant loads. Research has shown that the earlier decline can be detected, the more successful efforts will be in sustaining critical natural resources. While historically remote sensing (RS) has been successfully used to assess and monitor vegetation condition on a relative, coarse scale, advances in RS technologies and new modeling approaches now enable the identification and tracking of early and more subtle changes in vegetation condition, function, and structure. Here we review the current techniques used to assess and monitor forest ecosystem condition and disturbance and outline a general approach for earlier, more detailed, and accurate decline assessment. We also discuss the importance of engaging land managers, practitioners, and decision-makers in these efforts to ensure that the final products developed can be utilized by stakeholders to maximize the impact of these technologies moving forward.
Targeted suppression of soybean BAG6-induced cell death in yeast by soybean cyst nematode effectors

While numerous effectors that suppress plant immunity have been identified from bacteria, fungi, and oomycete pathogens, relatively little is known for nematode effectors. Several dozen effectors have been reported from the soybean cyst nematode (SCN). Previous studies suggest that a hypersensitive response-like programmed cell death is triggered at nematode feeding sites in soybean during an incompatible interaction. However, virulent SCN populations overcome this incompatibility using unknown mechanisms. A soybean BAG6 (Bcl-2 associated anthanogene 6) gene previously reported by us to be highly up-regulated in degenerating feeding sites induced by SCN in a resistant soybean line was attenuated in response to a virulent SCN population. We show that GmBAG6-1 induces cell death in yeast like its Arabidopsis homolog AtBAG6 and also in soybean. This led us to hypothesize that virulent SCN may target GmBAG6-1 as part of their strategy to overcome soybean defence responses during infection. Thus, we used a yeast viability assay to screen SCN effector candidates for their ability to specifically suppress GmBAG6-1-induced cell death. We identified several effectors that strongly suppressed cell death mediated by GmBAG6-1. Two effectors identified as suppressors showed direct interaction with GmBAG6-1 in yeast, suggesting that one mechanism of cell death suppression may occur through an interaction with this host protein.
Abstract 4609: TP53, PIK3CA, and BRAF somatic mutations in airway epithelial field of injury associated with lung cancer risk

Background: Lung cancer is the leading cause of cancer-related death in men and women, and cigarette smoking is the most significant preventable risk factor. Early detection through annual low dose CT screening reduces mortality but has low positive predictive value and specificity, in part due to low lung cancer incidence ( Methods: Synthetic DNA internal standards (IS) were prepared for each of 11 lung cancer driver genes and mixed with each AEC genomic (g)DNA specimen prior to competitive multiplex PCR amplicon NGS library preparation. A custom Perl script was developed to separate IS reads and respective specimen gDNA reads from each target into separate files for parallel variant frequency analysis. This approach enabled reliable detection of mutations with VAF as low as 5 x 10-4 (0.05%). This method was then applied in a retrospective case-control study. Specifically, AEC specimens were collected by bronchoscopic brush biopsy from the normal airways of 19 subjects, including eleven lung cancer cases and eight non-cancer controls, and the association of lung cancer risk with AEC driver gene mutations was tested. Results: TP53 mutations with 0.05-1.0% VAF were more prevalent (p Conclusions: Measurement of very low frequency mutations in the 0.05-1.0% VAF range enabled identification of an AEC somatic mutation field of injury associated with lung cancer risk. A biomarker comprising TP53, PIK3CA, and BRAF somatic mutations may better stratify individuals for optimal lung cancer screening and prevention outcomes. Citation Format: Daniel J. Craig, Thomas Morrison, Sadik Khuder, Erin L. Crawford, Leihong Wu, Joshua Xu, Thomas M. Blomquist, James C. Willey. TP53, PIK3CA, and BRAF somatic mutations in airway epithelial field of injury associated with lung cancer risk [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4609.
Discrepancies in the Recommended Management of Adrenal Incidentalomas by Various Guidelines.

Purpose:Adrenal incidentalomas are being discovered with increasing frequency, and their discovery poses a challenge to clinicians. Despite the 2002 National Institutes of Health consensus statemen...
Timed barium swallow for assessing long-term treatment response in patients with achalasia: Absolute cutoff versus percent change - A cross-sectional analytic study.

BACKGROUND Timed barium swallow (TBS) assesses esophageal emptying before and after therapy in patients with achalasia. Our aim was to compare the accuracy of percent change in barium height with traditional absolute cutoff of <5 cm on post-treatment TBS. MATERIALS AND METHODS Consecutive patients with treatment naive achalasia treated with either PD, HM, or POEM between 1/2012 and 7/2017 were eligible for inclusion. The accuracy of percent change in pre- and post-treatment barium height at 5 minutes versus an absolute <5 cm cutoff for assessing treatment response was assessed using the receiver operating curve analysis (ROC). RESULTS Eighty-one patients met the inclusion criteria. The median percent change in barium heights at five minutes in patients who did not improve was 6 percent increase (n = 10; mean 10.6) versus 78 percent decrease (n = 71; mean 64) in patients who improved (P = 0.0001). The AUC for percent change in TBS 5 minutes height was 76% (95% CI 48% to 90%), and a 3% decrease from baseline as a cutoff had a sensitivity of 60% and specificity of 99%. The AUC for post-treatment TBS 5 minutes height was 79% (95% CI 53% to 91%), and the 5 cm cutoff had a sensitivity of 70% and specificity of 75%. CONCLUSIONS The results show that 3% percent improvement in pre- and post-treatment barium height at 5 minutes rather than absolute cutoff value of <5 cm on post-treatment TBS is a better indicator of treatment success in achalasia patients. These findings indicate the need for reassessment of tools to identify treatment response.
High-latitude, Transluscent Molecular Clouds as Probes of Local Cosmic Rays

We analyze the gamma ray emission from nine high latitude, translucent molecular clouds taken with the Fermi Large Area Telescope between 250 MeV and 10 GeV. Observations of gamma rays allow us to probe the density and spectrum of cosmic rays in the solar neighborhood. The clouds studied lie within ~270 pc from the Sun and are selected from the Planck all-sky CO map. Gamma rays in this energy range mostly result from cosmic-ray interactions with the interstellar medium, which is traced with three components: H i, CO, and dark gas. Every cloud is detected and shows significant, extended gamma ray emission from molecular gas. The gamma ray emission is dominated by the CO-emitting gas in some clouds, but by the CO-dark gas in others. The average emissivity and gamma ray power law index from H i above 1 GeV shows no evidence of a systematic variation. The CO-to- conversion factor shows no variation between clouds over this small spatial range, but shows significant variations within each cloud. The average CO-to- conversion factor suggests that the CO-dark gas is molecular as opposed to optically thick H i.
Salting the earth: moral distress and the state of the US.

The combination of the US election ‘season’ and the devastation from the pandemic has left the country exhausted and in a shambles. The emotional and political wreckage from recent times has worked its way into the national character of America. Physicians, nurses, and staff have been particularly traumatised and exhausted after a year of constant death and uncertainty while living behind masks, shields, and other PPE with no real relief in sight. Clinicians and hospital employees feel a rising rage as they watch a lack of national leadership, health systems crumble, colleagues die, and their careers being permanently affected by circumstances. No clinician trains to be a pandemic doctor but they are nevertheless. Meanwhile, the newspapers are full of demonstrators and politicians who demand the freedom to infect their neighbours and families but will, of course, also demand the best of medical care when they are ill. Health professionals are being asked to save the lives of some people who seem determined to kill them. My colleague Will Miller, MD, refers to what we are experiencing as professional moral distress, which is a more profound concept than the …
Global Governance, Public Sphere, and CSOs

The public sphere and its concomitant concept, civil society, have recently become key ideas in global governance. Civil society organizations (CSO) have been appealing for global governance practitioners as these organizations may resolve the democratic deficits of global governance. An appeal to CSOs by considering them as agents of the global public sphere has merits as the starting point of this view is to enhance citizens’ participation and curb business groups’ interest in public policies. This chapter examines whether CSOs be idealized as the agents of critical public spheres in the transnational context. Interpretive theory unearths this public sphere assumption. Normative critical approaches to civil society that connect CSOs to the public spheres and the systemic approach to governance find their inspiration in Jurgen Habermas’s ideas when connecting civil society discourses to political and public spheres. However, the public sphere theory of Habermas loses its critical purchase when applied to the new governance. The public sphere theory and CSOs’ roles in creating a public sphere also face new dilemmas and challenges when these concepts are reconsidered beyond the nation-state. The most pressing challenges for CSOs is the technocratic-managerial nature of decision-making, the non-partisan interest aggregation system, and post-ideological presumptions of the new governance. CSOs are left with a significant dilemma of acting either constructively within governance networks or challenging hegemonic discourses for social justice and democratic self-government.
Stochastic response of bacterial cells to antibiotics: its mechanisms and implications for population and evolutionary dynamics

The effectiveness of antibiotics against bacterial infections has been declining due to the emergence of resistance. Precisely understanding the response of bacteria to antibiotics is critical to maximizing antibiotic-induced bacterial eradication while minimizing the emergence of antibiotic resistance. Cell-to-cell heterogeneity in antibiotic susceptibility is observed across various bacterial species for a wide range of antibiotics. Heterogeneity in antibiotic susceptibility is not always due to the genetic differences. Rather, it can be caused by non-genetic mechanisms such as stochastic gene expression and biased partitioning upon cell division. Heterogeneous susceptibility leads to the stochastic growth and death of individual cells and stochastic fluctuations in population size. These fluctuations have important implications for the eradication of bacterial populations and the emergence of genotypic resistance.
Management of Persistent Postoperative Air Leaks

The management of postoperative alveolar air leaks (AALs) continues to be a challenge for thoracic surgeons who routinely perform pulmonary resections. In order to ameliorate the impact of postoperative AALs, surgeons have incorporated the use of buttressed staple lines and topical sealants to manage intraoperative air leaks. In order to manage prolonged postoperative air leaks, surgeons have implemented Heimlich valves, pleurodesis, and blood patches. The direct clinical implications and evidence based use of these therapies are reviewed in this chapter. AALs can increase length of stay (LOS) and direct healthcare costs; however, these therapies used to mitigate AALs may be ineffective and may increase healthcare costs even more. This chapter provides a review of the current evidence-based literature that attempts to analyze the efficacy of the current therapeutic options that are available to prevent and reduce intraoperative and postoperative alveolar air leaks.
Sound recording popularity charts: A useful tool for music research

(1975). Sound recording popularity charts: A useful tool for music research. Popular Music and Society: Vol. 4, No. 2, pp. 86-99.
Tract-based probability densities of diffusivity measures in DT-MRI

We evaluate probability density functions of diffusivity measures in DTI fiber tracts as biomarkers. For this, we estimate univariate and bivariate densities, such as joint probability densities of the tract arc length and FA, MD, RD, and AD, in the transcallosal fibers in the brain. We demonstrate the utility of estimated densities in hypothesis testing of differences between a group of patients with VCI and a control group. We also use the estimated densities in classifying individual subjects in these two groups. Results show that these estimates and derived quantities, such as entropy, can detect group differences with high statistical power as well as help obtain low classification errors.
Dextromethorphan Abuse and Dependence in Adolescents

Dextromethorphan, a semi-synthetic morphine derivative, is a widely available antitussive in many over-the-counter cough and cold preparations. When taken in large amounts, it produces a high and effects similar to PCP. Emergency room and poison control data suggest that abuse of this substance has increased in the past decade. Adolescents, particularly those with co-occurring psychiatric and substance use disorders, seem to be at higher risk for abuse of and dependence on dextromethorphan than children and adults. Multiple case reports, including the one presented here, have demonstrated the symptoms of intoxication, the potential for abuse, the development of dependence, as well as the acute physical withdrawal and prolonged psychological withdrawal syndromes that can occur with dextromethorphan-containing products. Screening for substance use disorders is important in patients with any psychiatric disorder and should include questions regarding over-the-counter medications. For patients who present wit...
Curvature Flow Based 3D Surface Evolution Model for Polyp Detection and Visualization in CT Colonography

Computerized Tomography (CT) colonography is an emerging noninvasive technique for screening and diagnosing colon cancers. Since colonic polyps grow outward from the colon wall, they are modeled as protrusion shapes. In this chapter, we propose a novel anisotropic 3D surface evolution model for detecting protrusion shape based colonic polyp on the curved surface. The important feature of the proposed model is that it can detect protrusions with both convex and concave shapes. Protrusion shapes are defined as the extension beyond the usual limits or above a plane surface. Based on Gaussian and mean curvature flows, the approach works by locally deforming the convex or concave surface until the second principal curvature goes to zero. The diffusion directions are changed to prevent convex surfaces from converting into concave shapes, and vice versa. The deformation field quantitatively measures the amount of protrudeness. We also designed a new color coding scheme for better visualization of the detected polyps. The proposed method has been evaluated by using synthetic phantoms and real colon datasets.
CASE INVOLVING DIFFERENTIATION OF DEER AND HUMAN BONE FRAGMENTS

In a recent Louisiana forensic anthropology case, it was necessary to attempt species identification of six small bone fragments. The primary concern was whether or not they matched the fractured humerus of a woman killed by two shotgun blasts and then disposed of in the Mississippi River. These tiny fragments were recovered by law enforcement officers inside a jeep pickup and at the gas station where the vehicle had been cleaned. The police suspect claimed that these fragments were from a deer that he had recently killed. The small size of the pieces precluded positive recognition of human versus nonhuman origin based upon gross morphology and cortical thickness. Microscopic examination was possible. This analysis involved comparison of the unknown specimens to reference deer and human thin sections including bone recovered from the woman during autopsy. Examination of the jeep and gas station fragments revealed no plexiform bone, secondary (not primary) osteons, and variability in size and shape of the osteons and Haversian canals. These and other variables identified the bone fragments as human.
Chaotic Behavior and Pollution Dispersion Characteristics in Engineered Tidal Embayments: A Numerical Investigation1

: This paper presents a numerical investigation of approaches to enhance the mixing and dispersion processes in tidal areas by effecting changes in the natural estuary system. It compares the impact of various estuary modifications stemming from human intervention to pollutant dispersion and chaotic flow within the estuary including the implications of alteration of the original channel shape, change of the channel bathymetry, and modification of the tidal signal. Our findings indicate that chaotic flow analysis is similar in many regards, but not all, to conventional dispersion analysis. Specifically, we conclude that (1) simplification of the flow regime reduces chaotic flow patterns and tracer particle dispersion, (2) creation of extensively protruding barriers and/or installation of barriers on opposite sides of the main stem of the estuary enhances particle dispersion and chaotic mixing, (3) installation of underwater berms has relatively minor beneficial, but highly localized, effects on chaotic regime and particle dispersion, and (4) increasing the tidal signal amplitude was shown to increase chaotic and dispersion properties of the estuarine system. A parametric study investigating the effect of several geometrical configurations and tidal signals on characteristics of chaotic flows concludes the paper.
Agenda de paz y reformas: ¿qué se puede y qué se debe negociar?

Este articulo explora que elementos pueden y (probablemente) deben incluirse hacia el futuro en una agenda de negociaciones de paz entre el gobierno y los grupos guerrilleros en Colombia. A partir ...