cssi/SciSciGPT-SciSciNet huggingface dataset:
Research on Patient Satisfaction of Primary Medical Institution Based on Structural Equation

To investigate patients on 10 primary medical institution in Tianjin Binhai New Area,the path of affecting patient satisfaction and enhancing patient loyalty is revealed.By using the factor analysts,factors affecting patient satisfaction are dealt with,and the path of patient satisfaction and patient loyalty is build by structural equation model.Patient satisfaction is mainly affected by the attitude and behavior of doctor and nurse as well as the resource and cost of institution.The attitude and behavior of doctor and nurse has a direct positive function for patient satisfaction and patient loyalty,while the resource and cost of institution has a indirect effect.Efforts should be done to make concerted efforts between hardware and software,enhance service awareness,increase infrastructure investment,and improve patient loyalty.
Is there an exemplar theory of concepts

It is common to describe two main theories of concepts: prototype theories, which rely on some form of summary description of a category, and exemplar theories, which claim that concepts are represented as remembered category instances. This article reviews a number of important phenomena in the psychology of concepts, arguing that they have no proposed exemplar explanation. In some of these cases, it is difficult to see how an exemplar theory would be adequate. The article concludes that exemplars are certainly important in some categorization judgments and in category-learning experiments, but that there is no exemplar theory of human concepts in a broad sense.
Machines in the Garden

Ideas are inseparable from things and vice versa. Intellectual history and the history of material culture, accordingly, are not discrete endeavors: they are conjoined. Here is a guiding principle of our volume and the focus of the current section, “Things.” This chapter demonstrates these propositions for what is arguably the hardest case, the idea most reputed to have detached modern philosophy from the objects of daily experience: Descartes’s philosophical revolution cleaving mental self from mechanical body. A particular kind of machine, proliferating across the landscape of late medieval and early modern Europe, closely informed this philosophical revolution. Moreover, to approach the revolutionary philosophy in terms of the devices that informed it is to arrive at a kind of instability, a fault-line running through its very core.
Regulation of Direct Cell Type Specification in Early Development

This chapter provides information to gene regulation programs that control processes of direct cell type specification early in embryogenesis. In the bilateria, the most widespread, basic, and simple means of creating an embryo out of an egg depends on these direct specification mechanisms. Type 1 embryos display common phenomenological features, such as the early activation of embryonic genomes and territorial specification during cleavage leading at once to differentiation. These features are general because they utilize a common regulatory “deep structure.” The most important feature of the architecture of the genomic regulatory networks that initiate Type 1 embryonic processes is that they are remarkably shallow. They do not have a deeply hierarchical or multilayered structure. The regulatory transactions that these networks mediate occur during cleavage. Essentially, they depend on the information processing capabilities of key cis-regulatory elements, the job of which is to transduce the spatial inputs available in the early embryo into blastomere transcriptional regulatory states—this is called blastomere specification. As specification states are established, they are often supported by autostimulatory loops. The output of the specification process soon results in direct activation of differentiation gene batteries. The relation between specification state and the cellular organization of the Type 1 embryo is simplified by use of lineage relations—specification occurs in founder cells, and in later cleavage, these are divided into polyclonal territories of differentiated progeny, all without net growth.
Rash that itches and is all over: look beyond the skin

Generalized pruritic rash in Hodgkin's disease is most commonly due to paraneoplastic manifestation. It can sometimes precede other manifestations of Hodgkin's disease by weeks or months. Hence, if other possible causes have been ruled out, Hodgkin's disease should be considered a possible cause of generalized pruritic rash. Consideration of Hodgkin's disease as a cause of generalized pruritic rash can help in early identification of Hodgkin's disease. We present a case of a 71-year-old female who presented to the hospital with generalized pruritic rash for 4 days. Further workup revealed Stage IV Hodgkin's disease. The rash completely disappeared after receiving chemotherapy, which established that the rash was paraneoplastic manifestation of Hodgkin's disease.
Sampling-Based Path Planning for UAV Collision Avoidance

The ability to avoid collisions with moving obstacles, such as commercial aircraft is critical to the safe operation of unmanned aerial vehicles (UAVs) and other air traffic. This paper presents the design and implementation of sampling-based path planning methods for a UAV to avoid collision with commercial aircraft and other moving obstacles. In detail, the authors develop and demonstrate a method based on the closed-loop rapidly-exploring random tree algorithm and three variations of it. The variations are: 1) simplification of trajectory generation strategy; 2) utilization of intermediate waypoints; 3) collision prediction using reachable set. The methods were validated in software-in-the-loop simulations, hardware-in-the-loop simulations, and real flight experiments. It is shown that the algorithms are able to generate collision free paths in real time for the different types of UAVs among moving obstacles of different numbers, approaching angles, and speeds.
Approximate Query Engines: Commercial Challenges and Research Opportunities

Recent years have witnessed a surge of interest in Approximate Query Processing (AQP) solutions, both in academia and the commercial world. In addition to well-known open problems in this area, there are many new research challenges that have surfaced as a result of the first interaction of AQP technology with commercial and real-world customers. We categorize these into deployment, planning, and interface challenges. At the same time, AQP settings introduce many interesting opportunities that would not be possible in a database with precise answers. These opportunities create hopes for overcoming some of the major limitations of traditional database systems. For example, we discuss how a database can reuse its past work in a generic way, and become smarter as it answers new queries. Our goal in this talk is to suggest some of the exciting research directions in this field that are worth pursuing.
Nonprobability Sampling and Twitter

Twitter data are widely used in the social sciences. The Twitter Application Programming Interface (API) allows researchers to build large databases of user activity efficiently. Despite the potential of Twitter as a data source, less attention has been paid to issues of sampling, and in particular, the implications of different sampling strategies on overall data quality. This research proposes a set of conceptual distinctions between four types of populations that emerge when analyzing Twitter data and suggests sampling strategies that facilitate more comprehensive data collection from the Twitter API. Using three applications drawn from large databases of Twitter activity, this research also compares the results from the proposed sampling strategies, which provide defensible representations of the population of activity, to those collected with more frequently used hashtag samples. The results suggest that hashtag samples misrepresent important aspects of Twitter activity and may lead researchers to er...
Ability to Discriminate Between Sustainable and Unsustainable Heat Stress Exposures-Part 1: WBGT Exposure Limits.

Objectives Heat stress exposure limits based on wet-bulb globe temperature (WBGT) were designed to limit exposures to those that could be sustained for an 8-h day using limited data from Lind in the 1960s. In general, Sustainable exposures are heat stress levels at which thermal equilibrium can be achieved, and Unsustainable exposures occur when there is a steady increase in core temperature. This paper addresses the ability of the ACGIH® Threshold Limit Value (TLV®) to differentiate between Sustainable and Unsustainable heat exposures, to propose alternative occupational exposure limits, and ask whether an adjustment for body surface area improves the exposure decision. Methods Two progressive heat stress studies provided data on 176 trials with 352 pairs of Sustainable and Unsustainable exposures over a range of relative humidities and metabolic rates using 29 participants wearing woven cotton clothing. To assess the discrimination ability of the TLV, the exposure metric was the difference between the observed WBGT and the TLV adjusted for metabolic rate. Conditional logistic regression models and receiver operating characteristic curves (ROC) along with ROC's area under the curve (AUC) were used. Four alternative models for an occupational exposure limit were also developed and compared to the TLV. Results For the TLV, the odds ratio (OR) for Unsustainable was 2.5 per 1°C-WBGT [confidence interval (CI) 2.12-2.88]. The AUC for the TLV was 0.85 (CI 0.81-0.89). For the alternative models, the ORs were also about 2.5/°C-WBGT, with AUCs between 0.84 and 0.88, which were significantly different from the TLV's AUC but have little practical difference. Conclusions This study (1) confirmed that the TLV is appropriate for heat stress screening; (2) demonstrated the TLV's discrimination accuracy with an ROC AUC of 0.85; and (3) established the OR of 2.5/°C-WBGT for unsustainable exposures. The TLV has high sensitivity, but its specificity is very low, which is protective. There were no important improvements with alternative exposure limits, and there was weak evidence to support metabolic rate normalized to body surface area. In sum, the TLV is protective with an appropriate margin of safety for relatively constant occupational exposures to heat stress.
Punishment and the Burden of Proof

Justifying state punishment presents a difficulty for those who deny that human actions are free in the sense required by moral responsibility. The argument I make in this paper, following work done by Double, Vilhauer, and Sehon, is that those who believe that human beings do sometimes act freely face exactly the same difficulty, for no current account of freedom has the sort of evidentiary support that condemning a person to punishment requires; no current account could meet even the most minimal burden of proof. Recourse to purely preventive methods, such as are proposed for a system of quarantine of dangerous individuals, seems undesirable because of the absence of limits under such a system, limits like the requirements of proportionality and guilt. That same objection holds as well against proposals of non-retributive punishment: the adoption of a system of punishment, understood retributively or non-retributively, does not preclude the state even in theory from also adopting a system of preventive measures. The answer that I suggest is a system of limited deprivations of freedom justified in much the way the doctrine of takings is justified, along with the specific exclusion of purely preventive methods for competent individuals.
Information Relaxation Bounds for Infinite Horizon Markov Decision Processes

We consider the information relaxation approach for calculating performance bounds for stochastic dynamic programs (DPs), following Brown et al. [Brown DB, Smith JE, Sun P (2010) Information relaxations and duality in stochastic dynamic programs. Oper. Res. 58(4, Part 1):785–801]. This approach generates performance bounds by solving problems with relaxed nonanticipativity constraints and a penalty that punishes violations of these constraints. In this paper, we study infinite horizon DPs with discounted costs and consider applying information relaxations to reformulations of the DP. These reformulations use different state transition functions and correct for the change in state transition probabilities by multiplying by likelihood ratio factors. These reformulations can greatly simplify solutions of the information relaxations, both in leading to finite horizon subproblems and by reducing the number of states that need to be considered in these subproblems. We show that any reformulation leads to a lowe...
The Two Trips and Petitions to the Center of the Empire

A detailed consideration and analysis of Kenyatta’s famed two trips to Britain to present petitions to the Colonial Office. No book exists that cites from actual petitions, their intent and objectives, and Kenyatta’s reply to memoranda from the Colonial Office. An analysis of Kenya’s state of formative nationalism and the power of the white settlers in Kenya in the 1920s and beyond. This chapter also considers Kenyatta’s trip to the Soviet Union and the subsequent political fall-out. Why the decision to go and present the petitions in London? Was this the strategy of choice for the colonized at this period? What did Kenyatta see as the benefits of these trips to his people in Kenya?
Abstract 007: Obstructive Sleep Apnea Induced Hypertension Involves Gut Dysbiosis and Neuroinflammation

Obstructive sleep apnea (OSA) is an independent risk factor for systemic hypertension, and the most common underlying cause of resistant hypertension. The importance of a healthy gut microbiota on ...
Rates and risk factors associated with hospitalization for pneumonia with ICU admission among adults

Pneumonia poses a significant burden to the U.S. health-care system. However, there are few data focusing on severe pneumonia, particularly cases of pneumonia associated with specialized care in intensive care units (ICU). We used administrative and electronic medical record data from six integrated health care systems to estimate rates of pneumonia hospitalizations with ICU admissions among adults during 2006 through 2010. Pneumonia hospitalization was defined as either a primary discharge diagnosis of pneumonia or a primary discharge diagnosis of sepsis or respiratory failure with a secondary diagnosis of pneumonia in administrative data. ICU admissions were collected from internal electronic medical records from each system. Comorbidities were identified by ICD-9-CM codes coded during the current pneumonia hospitalization, as well as during medical visits that occurred during the year prior to the date of admission. We identified 119,537 adult hospitalizations meeting our definition for pneumonia. Approximately 19% of adult pneumonia hospitalizations had an ICU admission. The rate of pneumonia hospitalizations requiring ICU admission during the study period was 76 per 100,000 population/year; rates increased for each age-group with the highest rates among adults aged ≥85 years. Having a co-morbidity approximately doubled the risk of ICU admission in all age-groups. Our study indicates a significant burden of pneumonia hospitalizations with an ICU admission among adults in our cohort during 2006 through 2010, especially older age-groups and persons with underlying medical conditions. These findings reinforce current strategies aimed to prevent pneumonia among adults.
Diagnosis of Myasthenia Gravis

Myasthenia gravis (MG) diagnosis is primarily clinically based. By the end of the clinical evaluation, clinicians have a sense as to whether presenting symptoms and elicited signs are weakly or strongly supportive of MG. Diagnostic tests can reaffirm the clinicians' impression. Edrophonium testing is rarely used but helpful in cases of measurable ptosis. Decremental response on slow-frequency repetitive nerve stimulation has a modest diagnostic yield in ocular MG but is helpful in generalized MG cases. The most sensitive test is single-fiber electromyography. In this article, the authors review the diagnostic testing approach of practicing clinicians for suspected MG cases.
Returns to Scale and Efficiency in Production: A Distance Function Approach to Southern Illinois Hog Farms

In this paper, we introduce a parametric specification of a ray-homothetic input distance function. We choose to parametrice our distance function in such a manner that it becomes log-linear in the parameters. This choice enables us to utilize a generalized version of Aigner and Chu (1968) to compute the parameters of the function as solutions to a linear programming problem. The purpose of these theoretical developments are to formulate a framework for the measurements of scale elasticity and input efficiency. The analysis follows ideas introduced by Farrell (1957) and it is applied to the U.S. agricultural sector. The approach followed in this paper allows for a multiple output technology and does not require knowledge of prices. In addition, our methodology allows us to explicitly study the notion of scale elasticity and technical efficiency with respect to output size (in a multi-output setting) and output mix.
MRI for Detection and Evaluation of Hepatocellular Carcinoma

MRI is a useful method of imaging the cirrhotic liver, including for detection and evaluation of hepatocellular carcinoma (HCC), both for its initial diagnosis and following its response to management. In this chapter, we discuss features which allow distinction of HCC from other lesions in the cirrhotic liver, such as regenerative nodules, confluent fibrosis, and benign enhancing pseudonodules. One major strength of MRI is its use of multiple pulse sequences, analogous to the use of various stains for histopathology. Pulse sequences with unique value for characterizing focal liver lesions include T1-weighted, T2-weighted, lipid-sensitive, and multiphasic contrast-enhanced images. Features that facilitate diagnosis of HCC include its shape, capsule, internal nodularity, signal intensity, and sequential pattern of dynamic contrast enhancement. It is particularly important that radiologists and clinicians reach understanding on terminology for expressing confidence that a given focal lesion is HCC or benign, so that reported findings are most useful for guiding management decisions. A suggested framework for categorizing this confidence is provided.
Native-valve endocarditis caused by Staphylococcus epidermidis. A histologically confirmed case

Staphylococcus epidermidis is among the most common organisms isolated from blood cultures. Conversely, it is rarely a well-documented cause of natural-valve endocarditis. However, several authors have reported series of patients with the clinical picture of endocarditis and S. epidermidis bacteremia. Most of these cases have not been confirmed by examination of the valve. The authors present a case of natural-valve endocarditis caused by S. epidermidis with pathologic documentation of the offending agent.
The Neutrophil N-Formyl Peptide Receptor: Dynamics of Ligand-Receptor Interactions and Their Relationship to Cellular Responses

The N-formyl peptides, as a class, evoke in neutrophils in vitro an array of responses that mimic the biological functions of these cells in the inflammatory process. Because these peptides can be prepared synthetically, it has been possible to correlate extensively the structure-function relationships of a variety of amino acid sequences in both stimulatory and inhibitory peptides. Moreover,.this diversity in available sequences has permitted the development not only of numerous radiolabeled ligands, but of photoaffinity and fluorescent molecules as well. During the short period since N-formyl-methionyl peptides were first identified as chemoattractants derived from bacteria, the N-formyl peptides receptor has been catapulted into a position of prominence as a model, not only for studies of neutrophil stimulation but for receptor-mediated cell stimulation in general.
Single-dose versus 7-day-dose metronidazole for the treatment of trichomoniasis in women: an open-label, randomised controlled trial.

Summary Background Among women, trichomoniasis is the most common non-viral sexually transmitted infection worldwide, and is associated with serious reproductive morbidity, poor birth outcomes, and amplified HIV transmission. Single-dose metronidazole is the first-line treatment for trichomoniasis. However, bacterial vaginosis can alter treatment efficacy in HIV-infected women, and single-dose metronidazole treatment might not always clear infection. We compared single-dose metronidazole with a 7-day dose for the treatment of trichomoniasis among HIV-uninfected, non-pregnant women and tested whether efficacy was modified by bacterial vaginosis. Methods In this multicentre, open-label, randomised controlled trial, participants were recruited at three sexual health clinics in the USA. We included women positive for Trichomonas vaginalis infection according to clinical screening. Participants were randomly assigned (1:1) to receive either a single dose of 2 g of metronidazole (single-dose group) or 500 mg of metronidazole twice daily for 7 days (7-day-dose group). The randomisation was done by blocks of four or six for each site. Patients and investigators were aware of treatment assignment. The primary outcome was T vaginalis infection by intention to treat, at test-of-cure 4 weeks after completion of treatment. The analysis of the primary outcome per nucleic acid amplification test or culture was also stratified by bacterial vaginosis status. This trial is registered with ClinicalTrials.gov , number NCT01018095 , and with the US Food and Drug Administration, number IND118276, and is closed to accrual. Findings Participants were recruited from Oct 6, 2014, to April 26, 2017. Of the 1028 patients assessed for eligibility, 623 women were randomly assigned to treatment groups (311 women in the single-dose group and 312 women in the 7-day-dose group; intention-to-treat population). Although planned enrolment had been 1664 women, the study was stopped early because of funding limitations. Patients in the 7-day-dose group were less likely to be T vaginalis positive at test-of-cure than those in the single-dose group (34 [11%] of 312 vs 58 [19%] of 311, relative risk 0·55, 95% CI 0·34–0·70; p Interpretation The 7-day-dose metronidazole should be the preferred treatment for trichomoniasis among women. Funding National Institutes of Health.
Optimizing RF and Microwave Circuits for Radar Systems Design [Book\/Software Reviews]

This book presents practical techniques to optimize RF and microwave circuits for application in radar systems design with an emphasis on current and emerging technologies. Professionals will learn how to design RF components for radar systems and choose appropriate materials and package methods. It explains how to integrate components while avoiding higher-level assembly issues and troubleshooting problems on the measurement bench. The book is divided into three sections, the first of which introduces the basics of microwave design, including transmission line theory and common materials used in RF circuits. The methods for creating accurate device models for both passive and active circuit are also presented. The second section details the design of power amplifiers and includes ample “tips and tricks.” The last section concludes with a focus on component integration, providing detail on design methods for military operations, high manufacturing yield, and preventing measurement issues. This book includes a great deal of practical RF/microwave engineering knowledge to solve real-world issues, not only in designing but in manufacturing as well. Every RF/microwave engineer should have a copy
Dioquis: Being without doing in the migrant agricultural labor process:

Being on call without being on the clock is an important but underappreciated source of insecurity among low-wage workers. Drawing on fieldwork with 20 agricultural workers of the Texas-Mexico bord...
Active and Inactive Frames Improve Figure of Merit of Two Dimensional Mode Resonators

This paper introduces a new technique to enhance the figure of merit (FoM) of aluminum nitride (AlN) two dimensional mode resonators (2DMRs). This approach relies on the inclusion of metal frames at the edges of the electrode gratings and between each resonator finger to increase the compliance of these regions. In this way, the vertical displacement component resembles a quasi-square wave under the electrodes, boosting the electromechanical coupling $(k_{t}^{\ 2})$ , and the lateral displacement component stays confined within each finger, boosting the quality factor (Q). To demonstrate the proposed technique a 1-finger framed 2DMR operating at 2. $35\text{GHz}$ is simulated. By properly designing the metal frames and assuming uniquely acoustic losses, $k_{t}^{\ 2}=7\%$ and $Q$ =1300, which results in a FoM=91 (74% larger than the one previously reported).
Monitoring Selected Species of Mammals in Grand Teton National Park in 1999

Studies that investigate community relationships among mammals typically require large temporal and areal scales (Krebs et al. 1995; Estes 1996; Terborgh et al. 1999). Despite the difficulties presented by larger scales, such studies are valuable to decision-makers (Sinclair 1991; Smith et al. 1999). Understanding abundance, distribution, habitat choice, and ecological interactions of mammalian species can promote management decisions that benefit overall ecosystem health. Monitoring programs that build an ecological model of the landscape, and assess the trends in relation to biotic and abiotic changes, are essential to adaptive management, yet are seldom a standard part of management activities (Sinclair 1991; Noss and Cooperrider 1994; Lancia et al. 1996; Noss et al. 1996). Indeed, a conservation plan requires a longÂ­term obligation to standardized ecological monitoring so that actions can be adjusted according to new information (Noss et al. 1996). Over the long term, this standardized monitoring plan will provide information on small and medium-sized mammals that will (1) assess species use of habitat, (2) monitor changes in species composition as a result of environmental change, (3) produce predictive models of small and mediumÂ­sized mammal distribution based on vegetation type, and (4) analyze the impact of wolf (Canis lupus) colonization on the mammal (and plant) community. Such standardized monitoring techniques for mammal communities have not been done in the Greater Yellowstone Ecosystem. The abundance and diversity of mammals can be greatly affected by a number of factors. These include plant productivity (Hunter and Price 1994; Krebs et al. 1995; Polis and Strong 1996), climate (Pinter 1996; Hoogland 1995; Post et al. 1999), natural disturbance (Pickett and White 1985), disease (Dobson and May 1986), and expected or unexpected environmental change (Lancia et al. 1996; Thompson et al. 1998).
A study in the sedimented origins of evidence : Husserl and his contemporaries engaged in a collective essay in the phenomenology and psychology of epistemic justification

Etude de la critique de la definition de l'evidence comme sentiment developpee par Husserl dans les «Prolegomenes a la logique pure» et dans les «Recherches logiques», qui entreprennent une refutation systematique de la logique psychologiste defendue par Mill, Sigwart, Wundt, Hofler, Elsenhans et Rickert. Examinant les positions de Hume, Schleiermacher et des principaux representants de la phenomenolgoie classique de l'evidence que sont Ziegler, Eisler, Ziehen, Schmidkunz, Isenkrahe, Geyser, Brentano, Meinong, Schlick et Heidegger, l'A. conclut en montrant que l'incapacite des logiciens psychologistes a definir le type de sentiment qu'est l'evidence rejoint l'incapacite des logiciens phenomenologues a definir quel type d'experience de la verite est l'evidence consideree comme phenomene epistemique.
Urate levels predict survival in amyotrophic lateral sclerosis: Analysis of the expanded Pooled Resource Open‐Access ALS clinical trials database

Introduction: Urate has been identified as a predictor of ALS survival in some, but not all studies. Here we leverage the recent expansion of the PRO-ACT database to study the association between urate levels and ALS survival. Methods: Pooled data of 1,736 ALS participants from the PRO-ACT database were analyzed. Cox proportional hazards regression models were used to evaluate associations between urate levels at trial entry and survival. Results: After adjustment for potential confounders (i.e., creatinine and body mass index), there was an 11% reduction in risk of reaching a survival endpoint during the study with each 1 mg/dl increase in uric acid levels (adjusted HR: 0.89, 95% CI 0.82–0.97, p < 0.01). Discussion: Our pooled analysis provides further support to urate as a prognostic factor for survival in ALS and confirms the utility of the PRO-ACT database as a powerful resource for ALS epidemiological research. This article is protected by copyright. All rights reserved.
Effect of conditioner and moisture content on flowability of yellow cornmeal.

Flow characterization of ground materials based on standard physical properties is not always accurate and must be complemented with other properties that help characterize their flowability. The flow properties of yellow cornmeal as a function of moisture content (10.0%, 13.5% 17.0%, and 20.0% wet basis) and concentrations of added conditioner (calcium stearate, a caking agent classified at GRAS, at 0.50%, 0.75%, and 1.00% wt/wt) were measured. The optimum flow behavior characteristics of the cornmeal were achieved at 0.50% wt/wt calcium stearate and 10.0% (w.b.) moisture content based on the flow function test. Overall, the material's flowability decreased with increased moisture content based on very high values for Hausner's ratio, Carr's Index, and angle of repose. The flow index (ffc) obtained by the flow function test decreased from 6.47 to 3.82 as moisture increased, indicating increased cohesivity. Calcium stearate increased the flowability of the material at 0.50% wt/wt, beyond which the flowability was not affected (p > .05). Samples were very hygroscopic and classified as Class IV. The Hausner's ratio, Carr's Index, and angle of repose showed a strong linear relationship with the flow index with correlation values of 0.91, 0.88, and 0.88, respectively. Isotherms together with physical properties should be used to determine the flow characteristics of granulated materials such as yellow cornmeal to establish the best storage and processing conditions.
Plato’s Theory of the Arts in the Gorgias and in the Republic

This paper examines Socrates’ theory of the arts in the Gorgias and in the Republic. It shows how that theory changes, as the discussion takes focus first in relation to moderation, then to justice, where it is tied to the idea of a techne of rule, to notions of virtuous work and civic health, and to five levels of ‘art’ represented in the cave. It argues that both Socrates’ vision of a scientific and benevolent political art and Thrasymachus’ sophistic theory of tyrannical rule are undercut in the dialogue, the former by doubts concerning the epistemic closure it seems based on, the latter by the tyrant’s character, which impels him toward self-destructive government.
Abstract WMP5: CT Perfusion Profiles of Infarct Growth in Large Vessel Occlusion Acute Stroke Patients Sensitive to Decreases in Blood Pressure

The growth of a final infarct volume largely depends on cerebral perfusion after a large vessel occlusion (LVO) stroke. Decreases of blood pressure (BP) before recanalization are associated with la...
Attitudes towards contraception: focus groups with Arkansas teenagers and parents

Despite a national decline in teenage pregnancy rates, Arkansas continues to have one of the highest rates in the USA. More teenagers in the state reported not using any method of contraception (20...
AB0933 PHYSICAL ACTIVITY DECREASES PAIN AND INFLAMMATION IN GOUT PATIENTS

Background: Despite the high prevalence of gout, there has been little investigation into the relationship between physical activity and gout. Objectives: To investigate whether physically active gout patients, as assessed by the International Physical Activity Questionnaire (IPAQ) long form, have lower pain scores, decreased inflammation, assessed by C-reactive protein (CRP) levels and less flares. Methods: During scheduled appointments, gout patients not experiencing a flare at the time of visit were recruited from our clinics and consented to participate in the study. IPAQ were completed. Clinical data collected during the visit included age, years since diagnosis, flares per year, perceived pain at the time of visit and in the past 4 weeks, and C-reactive protein (CRP) levels. Results: Thirty gout patients were recruited. Ages 31-86 (mean 61); duration of gout: one- 43 years (mean 9). IPAQ, separated gout patients into physically active (n=16) and physically inactive cohorts (n=14) (p Conclusion: This is the first study using a validated physical activity tool, IPAQ, to assess physical activity in gout patients. In this study, physically active gout patients were found to have lower CRP levels, less flares per year, and decreased pain perception compared to those that are not physically active, highlighting, the importance of incorporating physical activity as a possible adjunct treatment option during intervals between flares. References: [1]Benatti FB, Pedersen BK. Exercise as an anti-inflammatory therapy for rheumatic diseases-myokine regulation. Nat Rev Rheumatol 2015;11:86-97. [2]Hagstromer M, Oja P, Sjostrom M. The International Physical Activity Questionnaire (IPAQ): a study of concurrent and construct validity. Public Health Nutr 2006;9:755-62. [3]Young NA, Jablonski K, Sharma J, Thomas E, Snoad B, Hampton J, et al. Low and Moderate Intensity Exercise Suppresses Inflammatory Responses in an Acute Mouse Model of Gout and Suggests Therapeutic Efficacy [abstract]. Arthritis Rheumatol. 2017;69 (suppl 10). Disclosure of Interests: Naomi Schlesinger Grant/research support from: Pfizer, AMGEN, Consultant of: Novartis, Horizon Pharma, Selecta Biosciences, Olatec, IFM Therapeutics, Mallinckrodt Pharmaceuticals, Speakers bureau: Takeda, Horizon, Kyle jablonski: None declared, Emmy schwarz: None declared, Nicholas Young: None declared
Morphology, Chemistry, and Genetics of Gossypium Adaptations to Pests

Gossypium is one of eight genera in the plant tribe Gossypieae in the family Malvaceae.1 The tribe Gossypieae is distinguished from related tribes by the production of spherical lysigenous glands located below the pallisade cells of cotyledons and leaves and throughout the bark of old roots and stems. The glands contain pigments which distinguish them from surrounding cells. Most of the pigments and other compounds in the pigment glands are toxic terpenoids and flavonoids. Thus, the glands apparently have evolved because of the added protection that they give against insects, rodents, and other herbivores.
3D-Printed Strain Sensors: Electro-Mechanical Simulation and Design Analysis Using Nonlinear Material Model and Experimental Investigation

This work is driven by the continuous improvement in additive manufacturing and the growing interest in developing flexible strain sensors with complex designs and structures. Characterization and analysis require not only understanding the mechanical behavior of the sensor but also the electrical behavior and the coupled electromechanical behavior. Traditionally, this coupled electromechanical behavior is determined using simplified approaches to establish a relationship between the electrical domain and mechanical domain. This work presents an experimental and numerical platform to characterize strain sensors and serves as a tool for design guidelines for these sensors. A nonlinear finite element COMSOL model is developed and validated against experiment. At 38% strain level the sensitivity is increased by 7% when the thickness,t, of the sensor decreased from t = 1.4 mm to t = 0.6 mm. A sensor with triangular embedded channels exhibits improved performance compared to square, hexagonal, and octagonal cross-sectional shapes. Three common channel patterns are examined including spiral, vertical serpentine, and horizontal serpentine patterns. Three commonly used materials for fabricating strain sensors are investigated including PDMS, EcoFlex, and NinjaFlex. At 35% strain level, a sensor with NinjaFlex substrate exhibits, approximately, 6% improvement in sensitivity, compared to a sensor with EcoFlex substrate.
Development and Assessment of Novel Multiligament Knee Injury Reconstruction Graft Constructs and Techniques.

Multiligament knee injury (MLKI) typically requires surgical reconstruction to achieve the optimal outcomes for patients. Revision and failure rates after surgical reconstruction for MLKI can be as high as 40%, suggesting the need for improvements in graft constructs and implantation techniques. This study assessed novel graft constructs and surgical implantation and fixation techniques for anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), posterior medial corner (PMC), and posterior lateral corner (PLC) reconstruction. Study objectives were (1) to describe each construct and technique in detail, and (2) to optimize MLKI reconstruction surgical techniques using these constructs so as to consistently implant grafts in correct anatomical locations while preserving bone stock and minimizing overlap. Cadaveric knees (n = 3) were instrumented to perform arthroscopic-assisted and open surgical creation of sockets and tunnels for all components of MLKI reconstruction using our novel techniques. Sockets and tunnels with potential for overlap were identified and assessed to measure the minimum distances between them using gross, computed tomographic, and finite element analysis-based measurements. Percentage of bone volume spared for each knee was also calculated. Femoral PLC-lateral collateral ligament and femoral PMC sockets, as well as tibial PCL and tibial PMC posterior oblique ligament sockets, were at high risk for overlap. Femoral ACL and femoral PLC lateral collateral ligament sockets and tibial popliteal tendon and tibial posterior oblique ligament sockets were at moderate risk for overlap. However, with careful planning based on awareness of at-risk MLKI graft combinations in conjunction with protection of the socket/tunnel and trajectory adjustment using fluoroscopic guidance, the novel constructs and techniques allow for consistent surgical reconstruction of all major ligaments in MLKIs such that socket and tunnel overlap can be consistently avoided. As such, the potential advantages of the constructs, including improved graft-to-bone integration, capabilities for sequential tensioning of the graft, and bone sparing effects, can be implemented.
Influence of Electric Taste, Smell, Color, and Thermal Sensory Modalities on the Liking and Mediated Emotions of Virtual Flavor Perception

Little is known about the influence of various sensory modalities such as taste, smell, color, and thermal, towards perceiving simulated flavor sensations, let alone their influence on people's emotions and liking. Although flavor sensations are essential in our daily experiences and closely associated with our memories and emotions, the concept of flavor and the emotions caused by different sensory modalities are not thoroughly integrated into Virtual and Augmented Reality technologies. Hence, this paper presents 1) an interactive technology to simulate different flavor sensations by overlaying taste (via electrical stimulation on the tongue), smell (via micro air pumps), color (via RGB Lights), and thermal (via Peltier elements) sensations on plain water, and 2) a set of experiments to investigate a) the influence of different sensory modalities on the perception and liking of virtual flavors and b) varying emotions mediated through virtual flavor sensations. Our findings reveal that the participants perceived and liked various stimuli configurations and mostly associated them with positive emotions while highlighting important avenues for future research.
Dilation-predominant approach versus routine care in patients with difficult-to-treat eosinophilic esophagitis: a retrospective comparison.

BACKGROUND Little is known about esophageal dilation as a long-term treatment approach for eosinophilic esophagitis (EoE). We examined the impact of a "dilate and wait" strategy on symptom management and safety of patients with EoE. METHODS This retrospective cohort study included two patient groups: those who underwent a dilation-predominant approach (≥ 3 dilations as sole therapy or for histologically refractory disease [> 15 eos/hpf]); and those who had routine care (< 3 dilations or histologic response). Group characteristics were compared and outcomes for the dilation-only group assessed. RESULTS 53/205 patients (26 %) received the dilation-predominant strategy (total 408 dilations), predominantly for histologic treatment nonresponse (75 %). These patients were younger (33 vs. 41 years; P = 0.003), had a narrower baseline esophageal diameter (9.8 vs. 11.5 mm; P = 0.005), underwent more dilations (7.7 vs. 3.4; P < 0.001), but achieved a smaller final diameter (15.7 vs. 16.7 mm; P = 0.01) vs. routine care. With this strategy, 30 patients (57 %) had ongoing symptom improvement, with esophageal caliber change independently associated with symptom response (adjusted odds ratio 1.79, 95 % confidence interval 1.16-2.78); 26 (49 %) used the strategy as a bridge to clinical trials. Over a median follow-up of 1001 days (interquartile range 581-1710), no deaths or dilation-related perforations occurred, but there were nine emergency room visits, including one for post-dilation bleeding and four for food impaction. CONCLUSIONS A dilation-predominant long-term treatment strategy allowed for symptom control or bridge to clinical trials for patients with difficult-to-treat EoE. Close follow-up and monitoring for complications are required.
Deltoid fascia disruption from the use of a bioinductive collagen scaffold and polyether ether ketone (PEEK) bone staples: a case report

Abstract Case We report the case of a 40-year-old woman with left shoulder pain and associated partial thickness rotator cuff disruption, biceps tendonitis, and subacromial bursitis. After primary rotator cuff repair with a bio-inductive implant, revision arthroscopy revealed a loose body and deltoid fascia impingement from a PEEK bone staple placed at the initial surgery, which resolved upon removal of the loose body and staple. Conclusion Proper insertion/utilization of the PEEK bone staples to ensure that they are inserted down to the bone and not proud is a simple solution that can be directly influenced by the treating surgeon.
Mapping the path forward to next generation algal technologies: Workshop on understanding the rules of life and complexity in algal systems

Abstract Algal technology offers enormous potential as a source of renewable biomass and bioproducts for fuels, biochemicals, nutrients, and numerous other applications. While tremendous opportunities exist, significant challenges are also present in harnessing and utilizing this valuable and potentially sustainable bioproduction platform. Funded by a joint partnership between the Bioenergy Technologies Office (BETO) at the Department of Energy (DOE) and the National Science Foundation (NSF), the recent virtual workshop, “Understanding the Rules of Life: Complexity in Algal Systems Workshop,” was organized to bring together thought leaders from academia, national laboratories and other government agencies, and industry to identify key challenges and propose research strategies to overcome these barriers. Two parallel sessions were undertaken: 1) algae strain and toolkit development and 2) algal ecosystem and microbiome dynamics, in order to advance algae engineering and cultivation efforts. In each session, attendees discussed the most pressing challenges from the perspective of model systems and omics analysis. Themes such as genetic engineering toolboxes, translation from the laboratory to outdoor cultivation, functional genomics, metabolomics, algal ecology, consortial design, microbiome dynamics, mathematical models, and data analytics emerged from the discussion. Overall, this workshop has served to elucidate the key hurdles and many opportunities present as we continue to advance algal science and technology from the laboratory and into the commercial realm.
Development of the free time motivation scale for adolescents.

A new self-report measure of adolescent free time motivation (FTMS-A) based in self-determination theory (Ryan & Deci, 2000) has been developed. The scale measures five forms of motivation (amotiva...
The Cognitive Artifacts of Designing. Lawrence Erlbaum Associates by Willemien Visser

The aim of the book is to present a cognitive descriptive model of design, considering design as the construction of representations, both internal (e.g., mental models) and external (e.g., drawing...
Blind modal identification of output-only structures in time-domain based on complexity pursuit: BLIND IDENTIFICATION OF MODAL PARAMETERS BASED ON COMPLEXITY PURSUIT

Output-only modal identification is needed when only structural responses are available. As a powerful unsupervised learning algorithm, blind source separation (BSS) technique is able to recover the hidden sources and the unknown mixing process using only the observed mixtures. This paper proposes a new time-domain output-only modal identification method based on a novel BSS learning algorithm, complexity pursuit (CP). The proposed concept—independent ‘physical systems’ living on the modal coordinates—connects the targeted constituent sources (and their mixing process) targeted by the CP learning rule and the modal responses (and the mode matrix), which can then be directly extracted by the CP algorithm from the measured free or ambient system responses. Numerical simulation results show that the CP method realizes accurate and robust modal identification even in the closely spaced mode and the highly damped mode cases subject to non-stationary ambient excitation and provides excellent approximation to the non-diagonalizable highly damped (complex) modes. Experimental and real-world seismic-excited structure examples are also presented to demonstrate its capability of blindly extracting modal information from system responses. The proposed CP is shown to yield clear physical interpretation in modal identification; it is computational efficient, user-friendly, and automatic, requiring little expertise interactions for implementations. Copyright © 2013 John Wiley & Sons, Ltd.
Long-term Follow-up of the Conaxial (Beck-Steffee) Total Ankle Arthroplasty

Between 1975 and 1977, 30 patients with traumatic arthritis or rheumatoid arthritis underwent 36 Conaxial (Beck-Steffee) ankle replacements (DePuy, Warsaw, IN). Thirty-two were primary replacements and four were revisions of previous ankle arthroplasties. Twelve patients had traumatic osteoarthritis and 18 patients had rheumatoid arthritis. The average age at operation of patients with rheumatoid arthritis was 61 years (range 28–67 years) and with osteoarthritis was 52.9 years (range 32–72 years). The average follow-up was 10.8 years, with a range of 10 to 13 years. Early postoperative complications included wound dehiscence in 39% of patients (14 patients), deep wound infection in 6%, fractures of the medial or lateral malleolus in 22%, and painful talofibular impingement in 14%. At 2-year follow-up, 27% of the ankle replacements were loose. Sixty percent were loose at 5 years and 90% were loose at the 10-year follow-up. Ten patients had implant removal and attempted fusion. Six, or 60%, fused in an aver...