cssi/SciSciGPT-SciSciNet huggingface dataset:
How bad TCP can perform in mobile ad hoc networks

Several recent studies have indicated that TCP performance degrades significantly in mobile ad hoc networks. This paper examines how badly TCP may perform in such networks and provides a quantitative characterization of this performance gap. Previous approaches typically made comparisons by ignoring the inherent dynamics such as mobility, channel error and shared-channel contention. Our work provides a realistic, achievable TCP throughput upper bound, and may serve as a benchmark for future TCP modifications in ad hoc networks. Our simulation findings indicate that node mobility, especially mobility-induced network disconnection and reconnection events, has the most significant impact on TCP performance. TCP NewReno merely achieves about 10% of a reference TCPs throughput in such cases. As mobility increases, the relative throughput drop ranges from almost 0% in the static case to 1000% in a highly mobile scenario (mobility speed is 20 m/sec). In contrast, congestion and mild channel error (say, 1%) have less visible effect on TCP (with less than 10% performance drop compared with the reference TCP).
S-adenosylmethionine: guanidinoacetate N-methyltransferase activities in livers from rats with hormonal deficiencies or excesses.

SummaryS-Adenosylmethionine: guanidinoacetate N-methyltransferase activities were determined in livers from rats after removal of either adrenals, pituitaries, gonads, or thyroids and parathyroids and in livers from intact rats given large doses of either insulin, estradiol, testosterone, cortisol, thyroxine, or growth hormone. The only differences that were statistically significant (p < 0.01) were between the activities of livers from intact rats and the slightly lower (~20%) activities of livers from rats with their thyroid and parathyroid glands removed or from intact rats given large doses of either testosterone, thyroxine, or growth hormone. Further, liver GA-methyltransferase activities were virtually unaffected by replacement of either thyroxine to thyroidectomized rats, growth hormone to hypophysectomized rats, or testosterone or estradiol to castrated rats. Therefore, direct hormonal regulation of rat liver GA-methyltransferase is contraindicated. Thus, the second enzyme involved in creatine syn...
The impact of diamonds on economic growth, adverse regime change, and democratic state-building in Africa:

Recent studies point to how resources such as diamonds have funded insurgency movements and how their geographic presence can foment the incidence but not necessarily the onset of civil wars. Such empirical studies are based on global models; however, we believe regional effects may be present. In order to address this, we disaggregate the empirical findings based on Africa as a region. By estimating a panel study of African states, we discover that those that are secondary diamond producers are not only vulnerable to domestic strife, but also prone to lower levels of economic growth, coup d’etat episodes, and state failure—conditions that inhibit democratic state-building. We also find that secondary diamond-producing states in Africa are prone to both the onset and incidence of civil wars, a finding that diverges from previous empirical work. In asking how states may obviate this curse, we affirm a claim of state developmentalism: that in order to prevent collapse, states must harness the revenue potent...
Family Experiences, Attitudes, and Household Safety Practices Regarding Firearms

To assess families' experiences with shootings and firearm ownership and attitudes, 208 children aged 5 to 12 years were interviewed and 242 parents filled out a questionnaire, all at an urban hospital. Forty-three percent of the parents and 25% of the children had personal knowledge of shootings. Of the parents, 10% owned guns, of which only 21% were stored safely. Gun ownership was more common in homes with resident adult males (14%) than in those with no adult males (3%). Most children (81%) played with guns, and 20% to 25% preferred violent TV shows, games, and toys. Parents' and children's attitudes toward firearms and children's gun play did not differ by level of mother's education; method of payment for, or site of, health care; income; or exposure to shootings. Children with personal knowledge of shootings more often expressed fears of being shot than did other children (52% vs 31%). The children in our study population were similar in their gun play and attitudes about gun use despite disparate socioeconomic backgrounds and exposure to shootings.
Film Growth: Control of Surface Morphology from Monodisperse Nanoparticles Through Fractals to Flat Epitaxial Heterostructures

The study of the morphology of surfaces produced by vapor deposition began over 125 years ago with Lord Kelvin. Since then, many researchers have addressed this topic from very different theoretical viewpoints, including thermodynamics, kinetics, fractal geometry, and numerical simulations. Only recently, however, have scanning probe microscopes become available to measure the three dimensional topography of a deposited film, which provided the quantitative experimental data necessary to test the different models of film growth. The concept of scaling provides a good first description of the morphology of vapor deposited films of all types, but for heteroepitaxial films, scaling is only approximately valid. The competition between the surface roughening caused by island nucleation and growth versus the smoothening actions of surface diffusion and desorption can lead to the formation of correlated structures on a surface with a dominant spatial frequency. By rational control of the film growth conditions, one can produce a surface covered by a low density of nearly monodisperse nanoparticles, an essentially fractal surface, or a planar film surface.
Developmental Trajectories of Anxiety and Depression in Early Adolescence

Adolescence is a period of heightened vulnerability for the onset of internalizing psychopathology. Characterizing developmental patterns of symptom stability, progression, and co-occurrence is important in order to identify adolescents most at risk for persistent problems. We use latent growth curve modeling to characterize developmental trajectories of depressive symptoms and four classes of anxiety symptoms (GAD, physical symptoms, separation anxiety, and social anxiety) across early adolescence, prospective associations of depression and anxiety trajectories with one another, and variation in trajectories by gender. A diverse sample of early adolescents (N = 1 065) was assessed at three time points across a one-year period. All classes of anxiety symptoms declined across the study period and depressive symptoms remained stable. In between-individual analysis, adolescents with high levels of depressive symptoms experienced less decline over time in symptoms of physical, social, and separation anxiety. Consistent associations were observed between depression and anxiety symptom trajectories within-individuals over time, such that adolescents who experienced a higher level of a specific symptom type than would be expected given their overall symptom trajectory were more likely to experience a later deflection from their average trajectory in other symptoms. Within-individual deflections in GAD, physical, and social symptoms predicted later deflections in depressive symptoms, and deflections in depressive symptoms predicted later deflections in GAD and separation anxiety symptoms. Females had higher levels of symptoms than males, but no evidence was found for variation in symptom trajectories or their associations with one another by gender or by age.
Formulation of a vector distance measure for the instantaneous-frequency distribution (IFD) of speech

The instantaneous-frequency distribution (IFD) of the outputs of a filter bank of overlapping band-pass channels (or the equivalent DFT implementation) has been proposed [1] as a short-time spectral measure useful for representing speech. For application of the IFD in conventional tasks such as word recognition, an appropriate vectorization is needed on which a useful distance function can be defined. A number of recent studies have shown the cepstral representation to be generally most effective in terms of recognition accuracy. We propose a "pseudo-cepstral" format which treats the IFD as if it were a log-power spectrum, with a matrix-weighted squared-Euclidean distance function. Comparative results are given for two forms of IFD as well as two conventional cepstral transforms, in a small-scale word-recognition task with added white Gaussian noise. In addition, a statistic is derived which is highly correlated with recognition error rates, but requires far less computation than is involved in an actual recognition trial.
Antiarrhythmic and electrophysiologic properties of UM-272, dimethyl quaternary propranolol, in the canine heart.

UM-272 [N,N-dimethyl-1-isopropylamino-3-(1-naphthyloxy)-propran-2-ol], a quaternary derivative of propranolol, was evaluated for its antifibrillatory effects in the anesthetized dog. The vulnerability to ventricular fibrillation was assessed by using trains of 60-Hz square-wave pulses of 5 mA intensity and 2 msec duration. UM-272, 5 mg/kg, raised the mean fibrillation threshold from 322 ± 20 msee to 599 ± 76 msec, an increase of 185%. After a total dose of 10 mg/kg, none of the five experimental animals developed ventricular fibrillation in response to the same test parameters. When the strength of the 60-Hz pulse was increased to 10 mA, only short bursts of ventricular tachycardia were observed. The vulnerability to ventricular fibrillation after experimental coronary artery occlusion was studied before and after UM-272. In control experiments, myocardial ischemia produced a 64% decrease in the duration of the train necessary to induce ventricular fibrillation. After UM-272, 5 mg/kg, the train duration was increased to 24% above the control value of the nonischemic myocardium. UM-272 decreased the rate of atrioventricular transmission, suppressed automaticity at idioventricular pacemaker sites and prolonged the ventricular effective refractory period. The antifibrillatory and antiarrhythmic effects of UM-272 suggest that it may be a valuable new antiarrhythmic agent in the management of arrhythmias associated with acute myocardial infarction.
Hyperbolic Conservation Laws and Compressible Flow

We begin this chapter by addressing general systems of hyperbolic conservation laws including numerical techniques for computing accurate solutions to them. Then we discuss the equations for one-phase compressible flow as an example of a system of hyperbolic conservation laws.
Nitrogen Doped 3D Titanium Dioxide Nanorods Architecture with Significantly Enhanced Visible Light Photoactivity

Surface-reaction-limited pulsed chemical vapor deposition (SPCVD) is able to create 3D TiO2-based hierarchical nanowire (NW) architecture with superhigh surface area and good electronic transport properties for high-performance photoelectrode development. However, how to intentionally dope the nanorods (NRs) through the SPCVD process to improve their electronic properties and light absorption behavior is still unexplored. In this paper, a comprehensive study of doping TiO2 NRs with nitrogen through the SPCVD technique is reported for the first time. The high-density nitrogen doped TiO2 NR branches with controlled doping concentrations were synthesized on dense Si NW forest by introducing designed number of TiN cycles to TiO2 growth cycles. Microscopic studies revealed the influence of nitrogen doping on the crystal growth behavior and NR morphology, as well as the elements distribution inside the lattices. Nitrogen doping lowered the band gap of TiO2 NRs and effectively activated visible light photoactivi...
The Chronic Pain Patient in the Emergency Department

Pain presentations are very common in the emergency department (ED), of which an estimated 12–16 % of total ED visits are from patients with chronic pain-related complaints (McLeod and Nelson in Australas Emerg Nurs J 16:30–36, 2013). The ED physician frequently has few tools to manage chronic pain patients, and is often times limited to pharmacological means of alleviating the patient’s suffering. For chronic pain patients, the ED only represents a fraction of their total longitudinal care. This article presents the scope of chronic pain, evaluation issues of the chronic pain patient, barriers to effective management, targeted pharmacotherapy suggestions, patient assessment strategies, prescribing guidelines, and other outpatient modalities used for treatment of chronic pain. The goal of this article is to improve the reader’s understanding of the issues surrounding the chronic pain patient and improve the care of these patients.
Prototype tests of assembly foundation of transmission line in aeolian sand area

The design of transmission line foundation in aeolian sand area is one of the key research topics in current power grid construction.Aeolian sand is special soil foundation;design in aeolian sand area has little relevant design basis.In the view of the characteristics of transmission line foundation engineering in aeolian sand area,the prototype tests of transmission line foundation are carried out.The deformation and bearing capacity,strain characteristics of the foundation and the contact pressure between the foundation and aeolian sand under the combination of uplift and horizontal load as well as the combination of pushdown and horizontal load are studied through the tests.According to the results,the design parameters of transmission line foundation in aeolian sand area are proposed.The test results provide a basis for design of foundations in Taiyuan-Tazhong 220 kV transmission line,which improve the reliability and rationality of the design of the transmission line foundation in aeolian sand area.
Symptoms and physiologic manifestations in obsessive compulsive patients before and after treatment with clomipramine

Background Anxiety and hyperarousal constitute important aspects of obsessive compulsive disorder (OCD). This study examined the effects of clomipramine on symptoms, arousal-related physiologic states, and stress reactions in OCD patients. Method Twenty-five OCD patients were randomly assigned to a clomipramine or placebo group and were assessed for 10 weeks using a double-blind parallel design. They were assessed clinically with the Yale-Brown Obsessive Compulsive Scale, the National Institute of Mental Health Global Obsessive-Compulsive Scale, the patient- and investigator-rated Global Improvement Scales, and the Hamilton Rating Scale for Depression. Prior to treatment, and again during the last day of medication, physiologic states (heart rate, respiration, skin conductance, blood pressure, and EMG) were measured at rest and during both nonspecific (psychomotor tasks) and pathology-specific (visualization) stressors. Results Patients taking clomipramine, but not those taking placebo, improved significantly on all clinical measures. With the exception of heart rate, treatment did not affect resting physiologic states. Heart rate increased in patients taking clomipramine and decreased in patients taking placebo. Autonomic reactivity to nonspecific and to pathology-specific stressors was attenuated by clomipramine, but not by placebo. Conclusion Clinical improvement on clomipramine treatment was independent of the physiologic state of the patients and was not associated with autonomic down-regulation. The attenuation of autonomic reactivity to stressors appears not to be pathology-specific but may reflect either a direct pharmacologic effect of clomipramine on the autonomic nervous system or a heightened indifference to psychological stressors in general.
Acute and Chronic Cardiovascular Responses to Sleep Disordered Breathing

Episodes of sleep disordered breathing are surprisingly common in asymptomatic, middle-aged individuals. The majority of these events are hypopneas, rather than apneas. Even though these events cause rather modest decreases in arterial oxygen saturation, they evoke substantial increases in arterial pressure. In this population, mild to moderate sleep disordered breathing is associated with elevated daytime blood pressure. The mechanisms responsible for the acute and chronic cardiovascular effects of sleep disordered breathing are incompletely understood. Chemoreflex mechanisms appear to be more important than intrathoracic pressure changes in causing the acute elevation in arterial pressure that occurs after obstructive sleep apnea. Arousal from sleep may contribute to this pressor response. either in an additive or synergistic manner. Relatively brief exposure to combined hypoxia and hypercapnia during wakefulness can produce an increase in sympathetic outflow to skeletal muscle that persists after return to room air breathing. This lingering post-asphyxic effect on sympathetic outflow may be the basis of chronically elevated sympathetic nervous system activity which accompanies sleep apnea syndrome and may contribute to sustained hypertension in these individuals.
Limits to Knowledge with Existential Significance: An Outline for the Exploration of Post-secular Spirituality of Relevance to Qualitative Research

This chapter is a truncated report on the second part of a three-part project I am currently working on. I am interested in post-secular frameworks for understanding spirituality, and its relevance to social research. By a post-secular understanding of spirituality, I mean an understanding of what is broadly referred to as spiritual in the West, but which emphasizes limits to knowledge and their existential significance. I do not mean anything having to do with metaphysics or religion or the idea of nonmaterial substances, beings, or entities aside from their importance as metaphors for what cannot be represented. I believe that this investigation has much relevance to social research, especially qualitative social research.
Different Mechanisms of Homologous and Nonhomologous Recombination in Brome Mosaic Virus, a Model Plant RNA Virus

Brome mosaic bromovirus, a tripartite, positive-stranded RNA virus of plants, can generate both homologous and nonhomologous intersegment RNA recombinants in vivo. The use of specially designed BMV RNA recombination vectors has demonstrated that recombination signals in the RNAs were different for these two recombination types. Specifically, nonhomologous recombination requires the formation of local double-stranded regions between the recombining RNAs while homologous recombination is facilitated by AU-rich sequences in conjunction with upstream GC-rich regions, common in the RNA substrates. These features most likely reflect different mechanisms involved in homologous and nonhomologous crossovers for this RNA virus.
Boosting with Adaptive Sampling for Multi-class Classification

Achieving scalability of learning algorithms has become an increasingly critical issue in knowledge discovery from "big data". Sampling techniques can be exploited as one of the approaches to address the issue of scalability. We present in this paper a method to employ a newly developed sampling-based ensemble learning method by boosting for multi-class (non-binary) classification. This current research extends our previous work on multi-class classification with sampling-based ensemble learning method, in which the base classifiers are the most simplistic, such as decision stumps. Here we generalize the sampling-based method to handle more complex base classifiers such as decision trees in building an ensemble, which require sampling a set of instances before building a base classifier. We present experimental results using bench-mark data sets from the UC-Irvine ML data repository that confirm the efficiency and competitive prediction accuracy of the proposed adaptive boosting method for the multi-class classification task.
Complex permittivity measurements of thin films using microdielectrometry

Classical dielectrometry illustrates how important information concerning the physical properties and state of a media can be obtained from the electrical frequency response. The modal approach to dielectrometry described here not only extracts its information from the control of the temporal frequency, but also from the imposition of a spatial periodicity as well. In this “imposed ω-k” technique, the medium is excited at the temporal (angular) frequency ω by means of an interdigital electrode structure having a spatial periodicity length X = 2π/k and hence a dominant wavenumber k.
Molecular characterization of the role of PTK2/FAK amplification in oral squamous cell carcinoma (OSCC)

3398 Background: The PTK2/FAK ( PTK2 ) gene on 8q24 codes for focal adhesion kinase (FAK), which is a critical nonreceptor tyrosine kinase involved in cell motility and growth. PTK2 has been implicated in many types of cancer including breast and ovarian, mainly through PTK2 expression studies on lymph node and distant metastasis. Previous genomic studies have identified PTK2 as an amplification target, setting the stage for this study of the genomic and expression alterations in PTK2 using a large set of primary oral squamous cell carcinomas (OSCCs). Study Design: Using high-resolution, array-based Comparative Genomic Hybridization (aCGH), we documented copy number alterations (CNAs) in 8q24.3, including PTK2 , in over 35 primary oral cavity squamous cell carcinomas (OSCCs). Results were confirmed using quantitative Real-Time PCR (Q-PCR). Total RNA isolated from the same tumors was hybridized to Affymetrix HG-U113A and HG-U113B microarrays to characterize the expression of genes identified by aCGH. This allowed identification of genes in regions of CNA that were also under or overexpressed. Immunohistochemistry (IHC) for PTK2 was performed on the same samples with varying CNAs of PTK2 , in order to characterize the result of the CNAs in OSCC tissues. We have also examined tumors with PTK2 amplification for the presence of additional cancer gene CNAs in order to identify interactions with molecular pathways associated with PTK2 overactivity. Results: The 8q24.3 amplicon harbors the genes T1 , EIF2C2, PTK2, GPR20 , and PTP4A3 , and was amplified in over 60% of our samples. Of the five genes studied, the only gene found to also be overexpressed in our OSCCs was PTK2 (p=0.0165). IHC using a monoclonal PTK2 antibody revealed elevated protein expression levels of PTK2 throughout the cytoplasm, in agreement with both the aCGH data and the RNA expression data. Finally, we have begun to examine the correlation of PTK2 amplification to the alteration of other genes involved in OSCC, and have found a positive correlation with genomic gains in BRCA1 in one subset, and with genomic losses in PTK2B in another subset of OSCCs. Conclusion: Using aCGH, Q-PCR expression profiling, and IHC we have identified PTK2 as the candidate gene most likely driving the 8q24.3 amplification, and shown that the amplification results in overexpression of PTK2 mRNA and protein in OSCC cells. We have also correlated amplification in PTK2 in additional subsets of OSCCs with CNAs in other cancer related genes, which we anticipate will shed light on the molecular pathways most involved in the evolution of OSCC.
Acoustic Measures of Voice and Physiologic Measures of Autonomic Arousal during Speech as a Function of Cognitive Load.

Summary Objectives/Hypothesis This study aimed to determine the relationship among cognitive load condition and measures of autonomic arousal and voice production in healthy adults. Study Design A prospective study design was conducted. Methods Sixteen healthy young adults (eight men, eight women) produced a sentence containing an embedded Stroop task in each of two cognitive load conditions: congruent and incongruent. In both conditions, participants said the font color of the color words instead of the word text. In the incongruent condition, font color differed from the word text, creating an increase in cognitive load relative to the congruent condition in which font color and word text matched. Three physiologic measures of autonomic arousal (pulse volume amplitude, pulse period, and skin conductance response amplitude) and four acoustic measures of voice (sound pressure level, fundamental frequency, cepstral peak prominence, and low-to-high spectral energy ratio) were analyzed for eight sentence productions in each cognitive load condition per participant. Results A logistic regression model was constructed to predict the cognitive load condition (congruent or incongruent) using subject as a categorical predictor and the three autonomic measures and four acoustic measures as continuous predictors. It revealed that skin conductance response amplitude, cepstral peak prominence, and low-to-high spectral energy ratio were significantly associated with cognitive load condition. Conclusions During speech produced under increased cognitive load, healthy young adults show changes in physiologic markers of heightened autonomic arousal and acoustic measures of voice quality. Future work is necessary to examine these measures in older adults and individuals with voice disorders.
Data placement on GPUs

Modern graphics processing unit (GPU) memory systems consist of a number of components with different properties. How data are placed on the various memory components often causes a significant difference in a program’s performance. This chapter discusses the complexity of GPU memory systems and describes a software framework named PORPLE to show how to automatically resolve the complexity for a given GPU program.
Divalent metal transporter DMT1 (SLC11A2)

This chapter will discuss the properties of DMTl and its relationship to iron uptake and iron trafficking (and the metabolism of other metals as well); we will describe the existing mutants representing specific transporter diseases in rodents. In addition, the chapter will further describe the potential contribution of DMT1 to diseases where SLC11A2 is not the gene mutated. Lastly, we will present insights derived from or to be gained from in vitro mutagenesis including a mutant in SLC11A1., DMT1 is the focus of two recent reviews (Andrews 1999; M.D. Garrick et al. 2003).
Mechanisms and characterization of impact damage in 2D and 3D woven fiber-reinforced composites

Abstract Low velocity impact damage of 2D and 3D woven glass/epoxy composites with the same areal density and material constituents were examined. Characterization of damage for both plate and beam sample geometries was investigated through the collection of high-resolution cross-sectional images after impact. Load and displacement data collected during impact testing reveals that the threshold load to introduce delamination damage is independent of the fabric architecture and is constant across a range of impact energies. Delamination length and opening of 3D woven composites was less than 2D composites impacted at the same energy as a result of suppression of delamination propagation and opening offered by the Z-tow reinforcement of the 3D fabric architecture. The formation of transverse shear cracks was independent of the fabric architecture.
The molecular autopsy: an indispensable step following sudden cardiac death in the young?

Annually thousands of sudden deaths involving young individuals (< 35 years of age) remain unexplained following a complete medicolegal investigation that includes an autopsy. In fact, epidemiological studies have estimated that over half of sudden deaths involving previously healthy young individuals have no morphological abnormalities identifiable at autopsy. Cardiac channelopathies associated with structurally normal hearts such as long QT syndrome (LQTS), catecholaminergic polymorphic ventricular tachycardia (CPVT), and Brugada syndrome (BrS), leave no evidence to be found at autopsy, leaving investigators to only speculate that a lethal arrhythmia might lie at the heart of a sudden unexplained death (SUD). In cases of autopsy-negative SUD, continued investigation, through the use of a cardiological and genetic evaluation of first- or second-degree relatives and/or a molecular autopsy, may pinpoint the underlying mechanism attributing to the sudden death and allow for the identification of living family members with the pathogenic substrate that renders them vulnerable to an increased risk for cardiac events, including sudden death.
Identifying African American Women with HIV Infection in an Expanded HIV testing and Linkage to Care (X-TLC) Program in Healthcare Settings on the South and West Sides of Chicago.

AbstractBackgroundWomen account for 25 % of HIV infections nationally, and African American (AA) women are disproportionately affected. We report important gender differences observed in an expanded HIV testing and linkage to care (X-TLC) program conducted on the South and West Sides of Chicago.MethodsX-TLC is funded by CDPH with CDC prevention B funds. X-TLC has expanded from 3 sites to 14 sites, including acute care hospitals (academic, community), community health centers (CHCs), and family planning clinics. We report descriptive stats, group comparisons by Chi-square, and multivariate analyses adjusted for demographics.ResultsSince 2011, X-TLC has conducted 308,038 HIV screens, and 63.7 % of those tested were women. Overall seroprevalence for HIV was 0.56 %, and 30.5 % of HIV patients identified were cis-gender women (seroprevalence 0.15 %). The seroprevalence for women testing in EDs was higher (0.44 %). Similar to men, only 52.9 % of HIV positive women were new diagnoses. Women accounted for 28.5 % of all new diagnoses, compared with 15.4 % for Chicago overall. In 2016 X-TLC screened 91,865 persons for HIV, and 65.2 % of those tested were women. There were 193 new diagnosis and 32.1 % (62) were women, 85.7 % AA. In comparison, in 2015 there were 139 women with a new HIV diagnosis for all of Chicago. Women newly diagnosed were less likely to be linked to care (adjusted odds ratio, aOR, 0.54, 0.35–0.85). Linkage was lower for women diagnosed at CHCs (84.6 % vs. 76.3 %, P = 0.02). Most CHCs did not have on site HIV providers. At our site, however, women linked to care were more likely to be retained in care (aOR 0.58, 0.43–0.78). We also conduct targeted outreach testing, partner services (PS) testing, and social network strategy (SNS) testing, but women are not identified by these programs (16/171 tested women, 8 new diagnoses were men for PS; 507 tested, 471 men and 36 trans-gender women, 38 new positives, 0 cis-gender women for SNS).ConclusionMore women than men were offered and/or accept HIV screening in healthcare settings. The proportion of seropositive women identified was higher than the national average. X-TLC is reaching a large proportional of AA women with HIV unaware of their status. Other testing strategies will rarely identify cis-gender women with HIV infection. Gender differences in linkage to and retention in care will require strategies targeted at women.Disclosures J. P. Ridgway, Gilead FOCUS: Grant Investigator, Grant recipient; N. Glick, Gilead FOCUS: Grant Investigator, Grant recipient; D. Pitrak, Gilead Sciences FOCUS: Grant Investigator, Grant recipient
Outcomes of Anterior Cruciate Ligament Reconstruction in Obese and Overweight Patients: A Systematic Review.

OBJECTIVE To evaluate the mechanism of injury, outcomes, and complications of anterior cruciate ligament (ACL) reconstruction in overweight and obese patients. DATA SOURCES MEDLINE, EMBASE, and OVID electronic libraries were systematically searched from inception to December, 2017 for any eligible articles using a combination of the phrases "anterior cruciate ligament," "ACL," "overweight," "obese," and "BMI." RESULTS Studies that evaluated patients with primary ACL reconstruction, classified patients as overweight or obese, and reported a minimum of 1-year follow-up data were included. Eight cohorts from 9 studies fulfilled the inclusion criteria. There were no significant differences for mechanism of injury, Lysholm scores, Knee injury and Osteoarthritis Outcome Scores values, or return to sports with a body mass index (BMI) above or below 25 kg/m. A significant difference was described in International Knee Documentation Committee (IKDC) scores when comparing obese patients (BMI >30 kg/m) to patients with BMI 25 kg/m, the risk for arthritis was significantly higher but the risk for revision surgery or contralateral ACL tear was lower (P <0.05). There was no significant difference in complication rates (P = 0.77). CONCLUSION Patient-reported outcome measures were similar for patients with BMI above and below 25 kg/m, but there is evidence that obese patients have lower IKDC scores. There is a consistent association between overweight status and developing arthritis among patients having an ACL reconstruction. Overweight and obese patients have a lower risk of revision ACL reconstruction and contralateral ACL tear. There is insufficient data to make any conclusions regarding mechanism of injury or complications. More research is needed to better understand what is the appropriate counsel and treatment for overweight or obese patients with ACL tears. PROSPERO REGISTRATION NUMBER CRD42017055594.
Varenicline for smoking reduction in smokers not yet ready to quit: A double-blind, proof-of-concept randomized clinical trial

Abstract Background Varenicline has demonstrated efficacy for quitting smoking. Its agonist and antagonist effects suggest that it would be efficacious for reducing cigarettes per day in smokers not yet ready to quit. Objectives To conduct a proof-of-concept placebo-controlled randomized clinical trial of varenicline for smokers willing to reduce, but not quit smoking. Methods Smokers (N = 53) were randomized to receive 28-days of varenicline plus brief counseling or 28-days of placebo plus brief counseling. They were instructed to reduce their cigarettes per day with the goal of reducing by 50% from baseline to end-of-treatment. Results Most (82.7%) participants attended all four counseling sessions and more than half took their medication as prescribed on at least 80% of days. Approximately half of our participants reported at least one adverse event, but no serious adverse events were reported or discovered. Although twice as many smokers receiving varenicline made a quit attempt as compared to those receiving placebo, the data did not support the hypothesis that taking varenicline would have a benefit over placebo in meeting a 50% smoking reduction goal. Those who reduced their cigarettes per day by at least 50% and those who reduced their CO intake by at least 50% from baseline to end-of-treatment showed higher self-efficacy for quitting at end-of-treatment, however. Conclusions These data support the proof-of-concept that smokers not ready to quit are willing to use varenicline while reducing the number of cigarettes smoked per day, and that successful reduction is associated with increased self-efficacy for later quitting.
Photothermal Sensing of Chemical Vapors Using Microcantilevers

Although microfabricated cantilevers have been used for detecting a variety of chemicals with high sensitivity, their selectivity appears to be poor. This selectivity problem is directly related to the poor selectivity of chemical interfaces immobilized on cantilever surfaces. Here we discuss two cantilever-based techniques that can be used for obtaining orthogonal signals for multimodal operation for enhanced selectivity. The first technique is based on photothermal deflection spectroscopy where selectivity is achieved through a mechanical response due to optical absorption by the adsorbed molecules on a cantilever. In the second technique, the position of the resonance frequency peak of the cantilever is monitored for shifting due to mass loading. This technique allows the precise measurement of the mass of the surface-adsorbed molecules. These two methods are demonstrated for adsorbed explosives.
Contemporary Interpersonal Approaches

Fancher is describing transference, which transformed Freud’s conception of neurosis and led to his consideration of the process of therapy in addition to the historical content of the client’s early memories. The transference dialectic revolves around three questions: Should therapy focus on the historical antecedents of problematic patterns? Should it focus on those patterns as they are recreated in the client’s current problems? Or should it confront the transference of those patterns into the therapy relationship?
Male Breast Cancer: Examining Gender Disparity in Diagnosis and Treatment.

Background Although men make up a small percentage of those diagnosed with breast cancer, they are usually diagnosed at a later stage than women, increasing their chance of mortality. The reasons for this gender disparity require additional study. Objectives This article examines current literature on male breast cancer, including reasons for the gender disparity and interventions that may help to address it. Methods An integrative review was conducted, and 12 studies were selected for inclusion. Findings Study consensus is that male breast cancer is an underresearched subject and that increased research efforts may improve outcomes. In addition, interventions could help to decrease the gender disparity in breast cancer detection.
Clear liquid diet before bowel preparation predicts successful chromoendoscopy in patients with inflammatory bowel disease.

Background and Aims Chromoendoscopy (CE) has been shown to generate both a superior diagnostic yield and dysplasia detection rate than conventional white-light endoscopy and requires a high-quality bowel preparation. The aim of this study was to identify predictors of the ability to perform CE in patients with inflammatory bowel disease (IBD). Methods We performed an observational study of patients with IBD undergoing colorectal cancer surveillance examinations with CE. Same-day colonoscopy surveys were used to collect patient and procedural variables. Multivariate logistic regression was used to establish odds ratios of successful completion of CE. Results Eighty-eight patients with IBD were enrolled. We found that patients who did not follow a clear liquid diet before colonoscopy had much lower odds of being able to undergo CE (odds ratio, 0.106; 95% confidence interval, 0.013-0.845; P Conclusions Following a clear liquid diet the entire day before the procedure was highly predictive of the ability to perform CE. However, established risk factors for inadequate bowel preparation did not inhibit the ability to perform CE in our population. Endoscopists performing CE should consider recommending that patients follow a clear liquid diet the entire day before their examination.
Combining PI3K/Akt/mTOR Inhibition With Chemotherapy

Abstract Since the discovery of rapamycin in the 1970s, much has been learned of the role of the PI3K/Akt/mTOR axis in cell survival. This vital pathway plays a central role in cell metabolism, growth, differentiation, proliferation, and survival in physiological and pathological conditions. It serves as a signaling pathway that is activated by growth factor receptor tyrosine kinases, G-protein coupled receptors, cytokine receptors, and integrin receptors. Dysregulation of this pathway has been associated with diseases such as diabetes, autoimmune diseases, and cancer. This pathway is one of the most frequently altered pathways in cancer, enabling cancer cells to survive and proliferate under stressful conditions. The PI3K/Akt/mTOR and insulin-like growth factor (IGF) signaling pathways have been shown to be hyperactivated in response to chemotherapy. Many cancers have been associated with aberrant IGF signaling, including prostate cancer, melanoma, osteosarcoma, pancreatic cancer, colon cancer, and childhood cancers. Activation of the PI3K/Akt/mTOR pathway has been associated with resistance to chemotherapeutic agents doxorubicin, daunorubicin, etoposide, cisplatin, and paclitaxel. Targeting the PI3K/Akt/mTOR signaling axis in cancer has shown promising results in preclinical studies in which combining PI3K/Akt/mTOR inhibitors with standard chemotherapy has been shown to attenuate chemotherapy resistance. In vitro and in vivo studies have led to clinical trials and FDA approval of rapalogs in the treatment of specific types of cancer. Because monotherapeutic strategies of signal-targeting or conventional chemotherapy frequently lead to resistance, numerous phase-I and phase-II clinical trials are underway combining PI3K/Akt/mTOR inhibitors with conventional chemotherapy. This chapter outlines the rationale and current status of clinical trials combining PI3K/Akt/mTOR inhibitors with conventional chemotherapy.
An Integrative Perspective on the Etiology of Substance Use

Advances in fields as diverse as sociology, behavioral science, education, developmental psychology, economics, neuroscience, and genetics are catalyzing a critical shift in the way we study the etiological underpinnings of substance use and addiction. As a result, science has entered an era of “demoralizing” substance use and addiction, and has embraced consistent, empirical observations that certain risk and resiliency factors influence the escalation of initial experimentation to problematic proportions. Increasing the precision of preventive and treatment approaches can be guided by our growing knowledge of underlying mechanisms in both etiological pathways and individual variability in intervention responsivity. This chapter presents the most recent conceptualization of these pathways defined by an “ecobiodevelopmental” theoretical framework.
Secure Endpoint Device Agent Architecture.

Software agents are installed on endpoint devices to monitor local activity, prevent harmful behavior, allow remote management, and report back to the enterprise. The challenge in this environment is the security of the agents and their communication with the enterprise. This work presents an agent architecture that operates within a high-security Enterprise Level Security (ELS) architecture that preserves end-to-end integrity, encryption, and accountability. This architecture uses secure hardware for sensitive key operations and device attestation. Software agents leverage this hardware security to provide services consistent with the ELS framework. This enables an enterprise to manage and secure all endpoint device agents and their communications with other enterprise services.
Association Between Liver Transplant Wait-list Mortality and Frailty Based on Body Mass Index.

Importance Among liver transplant candidates, obesity and frailty are associated with increased risk of death while they are on the wait-list. However, use of body mass index (BMI) may not detect candidates at a higher risk of death owing to the fact that ascites and muscle wasting are seen across transplant candidates of all BMI measurements. Objective To evaluate whether the association between wait-list mortality and frailty varied by BMI of liver transplant candidates. Design, Setting, and Participants A prospective cohort study was conducted at 9 liver transplant centers in the United States from March 1, 2012, to May 1, 2018, among 1108 adult liver transplant candidates without hepatocellular carcinoma. Exposures At outpatient evaluation, the Liver Frailty Index score was calculated (grip strength, chair stands, and balance), with frailty defined as a Liver Frailty Index score of 4.5 or more. Candidates’ BMI was categorized as nonobese (18.5-29.9), class 1 obesity (30.0-34.9), and class 2 or greater obesity (≥35.0). Main Outcomes and Measures The risk of wait-list mortality was quantified using competing risks regression by candidate frailty, adjusting for age, sex, race/ethnicity, Model for End-stage Liver Disease Sodium score, cause of liver disease, and ascites, including an interaction with candidate BMI. Results Of 1108 liver transplant candidates (474 women and 634 men; mean [SD] age, 55 [10] years), 290 (26.2%) were frail; 170 of 670 nonobese candidates (25.4%), 64 of 246 candidates with class 1 obesity (26.0%), and 56 of 192 candidates with class 2 or greater obesity (29.2%) were frail (P = .57). Frail nonobese candidates and frail candidates with class 1 obesity had a higher risk of wait-list mortality compared with their nonfrail counterparts (nonobese candidates: adjusted subhazard ratio, 1.54; 95% CI, 1.02-2.33;P = .04; and candidates with class 1 obesity: adjusted subhazard ratio, 1.72; 95% CI, 0.99-2.99;P = .06;P = .75 for interaction). However, frail candidates with class 2 or greater obesity had a 3.19-fold higher adjusted risk of wait-list mortality compared with nonfrail candidates with class 2 or greater obesity (95% CI, 1.75-5.82;P Conclusions and Relevance This study’s finding suggest that among nonobese liver transplant candidates and candidates with class 1 obesity, frailty was associated with a 2-fold higher risk of wait-list mortality. However, the mortality risk associated with frailty differed for candidates with class 2 or greater obesity, with frail candidates having a more than 3-fold higher risk of wait-list mortality compared with nonfrail patients. Frailty assessments may help to identify vulnerable patients, particularly those with a BMI of 35.0 or more, in whom a clinician’s visual evaluation may be less reliable to assess muscle mass and nutritional status.
Self-healing polymers with nanomaterials and nanostructures

Abstract Self-healing polymers have attracted a lot of attentions in the past two decades, driven by their intriguing applications, new synthetic approaches and understanding of nanoscale mechanism and discovery of nanomaterials. Nanomaterials and nanostructures in polymers provide large surface area, rich functional groups and unique properties that facilitate the healing process. This review provides an introduction of the key studies from a historical standpoint and the chronological advancement of the design philosophy behind self-healing phenomena of polymers. Recent advance in utilizing nanomaterials and nanostructures to facilitate the healing and introduce novel functionalities in self-healing polymers is extensively reviewed. In addition, innovative characterization methods are employed to analyze and understand the underlying polymer chain interactions occurring at the interface at micro- and nanoscale. The knowledge of the healing process at the nanoscopic level and the contribution of nanomaterials and nanostructures in self-healing has greatly advanced the design, fabrication and application of self-healing polymers.