cssi/SciSciGPT-SciSciNet huggingface dataset:
Obsessive-Compulsive Disorder

Previously classified as an anxiety-related disorder, obsessive-compulsive disorder (OCD) was moved to a new “Obsessive-Compulsive and Related Disorders” section in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association [APA], 2013). This section also includes body dysmorphic disorder (BDD), hoarding disorder (previously considered a subtype of OCD), trichotillomania (hair-pulling disorder), and excoriation (skin-picking disorder; APA 2013) (see Chap. x). In DSM-5, OCD is characterized by the presence of obsessions and compulsions (Criterion A), which must be time-consuming or cause clinically significant distress or impairment (Criterion B; APA 2013, p. 238). Obsessions are egodystonic “repetitive and persistent thoughts, images, or urges” (APA 2013, p. 238), while compulsions are “repetitive behaviors … that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly” (APA 2013, p. 237). Whereas obsessions are strictly mental activities, compulsions can be observable (e.g., checking locks or washing hands) or covert (e.g., counting or mentally repeating certain words or phrases).
The Need for a Preference‐Based Multicriteria Prioritization Framework in Life Cycle Sustainability Assessment

Summary Life cycle thinking is a valuable tool for integrated assessment of the environmental, social, and economic outcomes of human activities. The combination of the three as life cycle sustainability assessment (LCSA) is a powerful decision support tool, but it also presents important design challenges. Among the most important challenges is how to include subjective information necessary for defining the major elements of a decision: prospects to decide among, uncertainty, risk attitudes, and preferences. Previous work on values in life cycle methods has addressed prospects, uncertainty, and risk attitudes. This article builds on that work by arguing that given LCSA's broad scope, explicit and standardized intercategory preferences are especially important for improving its value for decision makers. Practitioners should not be solely responsible for the value judgments necessary to integrate impact categories within and across environmental life cycle assessment (E-LCA), social LCA (S-LCA), and life cycle costing evaluations for LCSA. Neither should this task fall entirely to decision makers, particularly as life cycle–grounded decisions are highly sensitive to value frames. Individuals are unlikely to be able to meaningfully interpret, evaluate, and determine trade-offs without support. This article thus proposes that LCSA leverage its multiple paradigms to rigorously generate explicit, empirically grounded intercategory preference archetypes for use in evaluating decision robustness, much as cultural theory-based archetypes are currently used to test robustness to risk attitudes. Proof-of-concept data from the United States illustrate this approach, named WELFARES.
Glycobiology of Eosinophilic Inflammation: Contributions of Siglecs, Glycans, and Other Glycan-Binding Proteins

The historical focus on protein-protein interactions in biological systems, at the expense of attention given to interactions between other classes of molecules, has overlooked important and clinically relevant processes and points of potential clinical intervention. For example, the significance of protein-carbohydrate interactions, especially in the regulation of immune responses, has recently received greater recognition and appreciation. This review discusses several ways by which cell surface lectin-glycan interactions can modulate eosinophil function, particularly at the levels of eosinophil recruitment and survival, and how such interactions can be exploited therapeutically. A primary focus is on discoveries concerning Siglec-8, a glycan-binding protein selectively expressed on human eosinophils, and its closest functional paralog in the mouse, Siglec-F. Recent advances in the synthesis of polymeric ligands, the identification of physiological ligands of Siglec-8 and Siglec-F in the airway, and the determination of the basis of glycan ligand discrimination of Siglec-8 are discussed. Important similarities and differences between these siglecs are outlined. Eosinophil expression of additional glycan-binding proteins or their glycan ligands, including interactions involving members of the selectin, galectin, and siglec families, is summarized. The roles of these molecules in eosinophil recruitment, survival, and inflammation are examined. Finally, the modulation of these interactions and potential therapeutic exploitation of glycan-binding proteins and their ligands to ameliorate eosinophil-associated diseases are considered.
Bone Health of Adolescent Athletes

Bone health is important for adolescent athletes to be able to participate safely and effectively in their chosen sport. In general, weight-bearing exercise is associated with increased bone strength and density, but when exercise is excessive or in the setting of energy expenditure exceeding energy output over an extended period, a stress fracture can result. Known risk factors for stress fractures include female gender, a history of previous stress fracture, and menstrual dysfunction. There are also particular sports that are associated with certain types of stress fractures, and runners are at high risk. The diagnosis of stress fracture is based on history and physical examination and supported by diagnostic imaging. Magnetic resonance imaging (MRI) is the most sensitive tool for detecting a stress fracture. Stress fractures are classified as high or low risk based on potential complications. Generally low-risk stress fractures heal with conservative therapy, whereas high-risk stress fractures may require surgical intervention. Diet and exercise are important lifestyle components affecting bone health. Athletes presenting with restrictive eating habits and/or menstrual dysfunction, calcium and vitamin D deficiencies, or a history of bone injuries may have increased calcium and vitamin D needs. Practitioners should stress the importance of consuming adequate energy and a diet focused on food variety (while still meeting the RDAs for calcium and vitamin D) for optimal performance, bone health, and injury prevention.
Democratic Formulation of D=10 Supersymmetry

We discuss a generalized form of IIA/B supergravity depending on all Ramond–Ramond (R–R) potentials C (p), p = 0,1,...,9, as the effective field theory of type-IIA/B superstring theory. For the IIA case, we explicitly break this R–R democracy to either p ≤ 3 or p≥ 5, which allows writing a new bulk action that can be coupled to N=1 supersymmetric brane actions.
Alloreactivity following in utero transplantation of cytokine-stimulated hematopoietic stem cells: The role of recipient CD4− cells☆

Abstract Objective We have previously reported immunity to donor antigens following in utero transplantation (IUT) of cytokine-stimulated allogeneic hematopoietic stem cells (sca + /lin − ) (day 9 of gestation). Transplanted mice showed accelerated rejection of donor skin grafts and high anti-donor cytotoxic response, a finding not seen in the control mice. This was accompanied by an enhancement of Th1 over Th2 cytokine production and persistent donor microchimerism [1,2]. In order to assess the role of the thymus in allograft rejection, prenatal transplants were performed under similar experimental conditions at a later gestational age, when the thymus is more developed (day 13). Materials and Methods Cytokine-stimulated stem cell factor (SCF) and granulocyte colony-stimulating factor (G-CSF)–purified sca + /lin − cells of C57BL/6 (H-2b, 1E + ) background were injected into MHC-mismatched BALB/c (H-2d, 1E − ) fetal mouse recipients at day 13 of gestation. Chimerism was determined by highly sensitive (0.001%) semiquantitative polymerase chain reaction (PCR) [3,4]. Mixed lymphocyte reaction (MLR) and cytotoxic T-cell assay (CTL) were used to evaluate tolerance vs immunity. Cytokine levels were quantified in MLR supernatants using ELISA assay. The percent of T cells was determined by flow cytometry (FACS) and CD4/CD8 ratio calculated. Postnatal boosts (transplants without conditioning) were performed at 6 months of age to enhance donor chimerism and test the degree of tolerance. Results When assayed at 4 months of age, donor-type cells were not detected in the spleen or in the peripheral blood of BALB/c mice inoculated with C57BL/6 sca + /lin − cells. Transplanted but not control animals demonstrated high anti-donor MLR but not CTL responses. The increase of MLR reactivity was correlated with high levels of IL-2. Furthermore, transplanted mice showed higher resistance to postnatal boosts with allogeneic bone marrow (BM) cells, when compared to the control mice. The later resistance was accompanied by the expansion of host-type CD4 cells. Conclusion These data demonstrate that transplantation of cytokine-stimulated sca + /lin − allogeneic cells at 13 days of fetal development leads to the allosensitization, characterized by an enhancement of MLR alloreactivity and by the rejection of postnatal boosts (transplants without conditioning). Host-type CD4 cells might play a central role in this rejection. These findings indicate that the late injection of allogeneic cells may result in the development of allosensitization with subsequent donor graft rejection. Precise conditions for the development of tolerance must be established before prenatal transplants in humans with conditions other than SCID can be done.
Combining the Sparsity and Unambiguity Biases for Grammar Induction

In this paper we describe our participating system for the dependency induction track of the PASCAL Challenge on Grammar Induction. Our system incorporates two types of inductive biases: the sparsity bias and the unambiguity bias. The sparsity bias favors a grammar with fewer grammar rules. The unambiguity bias favors a grammar that leads to unambiguous parses, which is motivated by the observation that natural language is remarkably unambiguous in the sense that the number of plausible parses of a natural language sentence is very small. We introduce our approach to combining these two types of biases and discuss the system implementation. Our experiments show that both types of inductive biases are beneficial to grammar induction.
Analytical Aspects of Drug Delivery: An Important and Often Overlooked Problem

A flurry of activity has recently taken place aimed at developing improved delivery systems for drugs. Such systems are being designed to release drugs at controlled rates, to selectively direct the agent to appropriate “target sites” (located either within or on the surfaces of particular cell types) while reducing drug exposure to “non-target” areas and to control the absorption, transport, distribution and cellular uptake of pharmacologically active agents. The motivation for these efforts include: (1) the realization that many candidate drugs that have been found clinically unsuitable would be therapeutically and commerically valuable if properly delivered, (2) interest in developing products derived from genetic engineering (and other compounds) as drugs whose potency, short biological and/or chemical half lives or peculiar disposition profiles necessitate controlled, regiospecific release from a formulation, (3) potential exploitation of cytotoxic agents (or other materials) with narrow therapeutic indices requiring precise temporal and spacial control of drug release, (4) therapeutic advantage gained by less fluctuation in drug levels, better patient compliance and ultimately “personalized” systems whose release program is responsive to physiological/pharmacological events and (5) marketing considerations.
Effect of Synthetic Fiber State on Mechanical Performance of Fiber Reinforced Asphalt Concrete

It has been recognized that there exists a potential benefit from using synthetic fibers to reinforce asphalt mixtures. In these mixtures, the state of the fibers may play an essential role in thei...
Neurodevelopmental outcomes at 2 and 4 years in children with congenital heart disease.

BACKGROUND AND OBJECTIVES Children with congenital heart disease (CHD) are at risk for neurodevelopmental (ND) delays. The purpose of this study is to compare the ND testing results of children with CHD at 2 and 4 years of age and determine if rates of ND delays change over time. METHODS Children with CHD completed the Bayley Scales of Infant Development-III (BSID-III) at 2 years of age, and standardized neuropsychological measures at 4 years. Scores were compared with test norms and were classified as: average (within one SD of test mean); at risk (1-2 SDs from the test mean); and delayed (>2 SD from test mean). Pearson correlations and McNemar's exact tests were performed to determine the relationship between test scores at the two times of assessment. RESULTS Sixty-four patients completed evaluations at 24 ± 3 months of age and 4 years of age. BSID-III cognitive and fine motor scores were correlated with preschool IQ and fine motor scores, r = .75 to .87, P < .0001. Agreement in score categories was 79% for cognitive and 61% for fine motor. More patients had at risk or delayed scores at age 4 vs age 2 (P ≤ .01). CONCLUSION(S) Despite significant correlations between 2- and 4-year-old test scores, many patients who scored in the average range at age 2 showed deficits at age 4. BSID-III scores at age 2 may underestimate delays. Therefore, longitudinal ND assessment is recommended.
The Impact of Non-Accelerated Filers and Auditor Switches on Information Risk

Shocks to the market for auditor services in the early 2000’s had the effect of shifting the provision of audit services to small public companies from a range of auditors to predominantly small audit firms. Concurrently, regulators eased audit and financial reporting disclosure requirements for small public companies. In this study, we examine the effects of auditor quality and regulatory regime changes on information risk for small (non-accelerated) compared to large (accelerated) public companies during 2003-2009. We view information risk as a joint function of the auditor and the client company. We employ market-based measures of information risk including e-loading (market sensitivity to the mapping of accruals onto cash flows) and return volatility (which also captures uncertainty about managers’ future disclosure and reporting choices). We consider auditor quality to be a function of auditor size and other auditor characteristics (e.g., industry expertise). We find that non-accelerated filers consistently have greater information risk than do accelerated filers, controlling for auditor and company characteristics, a result that is robust across types of model estimates (including auditor-client “mismatch” and a matched-pair analysis to control for self-selection bias). We find that changes from large auditors (Big 4 and Tier 2) to Tier 3 auditors increase (decrease) return volatility for accelerated (non-accelerated) companies. A “matched” auditor-client mitigates this result for accelerated companies. We find that lateral changes increase (decrease) e-loadings for non-accelerated (accelerated) companies. Finally, analyses of changes over a three-year period including the year of the auditor change, by type of change, indicate similar effects on our information risk proxies.
The effects of lead on algae

The effects of lethal and sublethal concentrations of PbCl2 on reproduction , viability, and motility of a marine unicellular green flagellate alga, Platymonas subcordiformis, were studied under controlled laboratory conditions. The severity of the effects depended primarily upon the concentration of Pb++ and the duration of treatment. Log phase cells were more sensitive than stationary phase cells. Sublethal amounts of Pb (2.5 and 10 mg l−1 Pb++) tended to retard population growth by delaying cell division and daughter cell separation. A lethal amount of Pb (60 mg I−1 Pb+) caused inhibition of growth and cell death. Various intracellular abnormalities resulted from Pb treatment. The flagella were shed or altered in a variety of ways, depending on Pb concentration; motility was least affected by low Pb and completely impaired by high Pb. Normal wild-type cells appeared to be more sensitive to Pb than mechanically sheared (flagella-less) cells and cells of a non-flagellate mutant of Platymonas. Exposure of cells to Pb in non-growth conditions of dark and cold (2°C) had little negative effect.
Acute Management of Hyperkalemia.

Hyperkalemia is a common electrolyte abnormality that can lead to life-threatening cardiac arrhythmia. Medical management of acute hyperkalemia revolves around three strategies—stabilizing the myocardium, intracellular shifting of serum potassium, and enhancing elimination of total body potassium via urinary or fecal excretion. In this review, we outline the current evidence behind the acute medical management of hyperkalemia. Two new oral potassium-binding agents, patiromer and sodium zirconium cyclosilicate, show promise in the management of hyperkalemia. Their role in the acute setting needs further investigation. Recent investigations also suggest that the optimal dosing of intravenous insulin may be lower than previously described. Despite its prevalence, there is wide variability in the medical management of hyperkalemia in the acute setting. High-quality evidence demonstrating efficacy is lacking for many medications, though novel oral potassium-binding agents show promise. Overall, more research is necessary to establish optimal dosing strategies to manage hyperkalemia in the acute setting.
The Virtue of Interprofessional Education.

It is a privilege and a joy to help celebrate Rick, a leader I admire and a friend I cherish. But he tested our friendship by giving me a hard assignment to talk about the virtue of interprofessional education (IPE). IPE is a passion for him, so I felt pressure to cover it well. And the connection
Impact of multimorbidity subgroups on the health care use of early pediatric cancer survivors

Background Although pediatric cancer survivors in the United States are at an increased risk of developing chronic conditions, to the authors' knowledge there is limited information regarding the types and combinations of conditions they experience in the years immediately after the completion of cancer therapy. Methods An observational cohort study of early pediatric cancer survivors (children who were ≥2 years from the end of therapy and aged ≤18 years) was conducted using the Truven Health MarketScan (r) Commercial Claims and Encounters database (2009-2014). Latent class analysis was used to identify comorbidity groups among the subset with ≥2 conditions. Group-level health care use was compared with survivors without chronic conditions using multivariate regression. Results A total of 3687 early survivors were identified, of whom approximately 41.2% had no chronic conditions, 22.5% had 1 chronic condition, and 36.3% had ≥2 chronic conditions. Among those with ≥2 chronic conditions, 5 groups emerged: 1) general pediatric morbidity (35.4%); 2) central nervous system (CNS) (22.4%); 3) mental health conditions (22.2%); 4) endocrine (26.2%); and 5) CNS with endocrine (3.8%). The CNS group experienced the highest expenditures, at $17,964 more per year (95% CI, $1446-$34,482) compared with survivors without chronic conditions. The CNS group also had the highest odds of an emergency department visit (adjusted odds ratio, 1.71; 95% CI, 1.15-2.56). The endocrine group had the highest odds of hospitalization (odds ratio, 2.29; 95% CI, 1.24-4.22). Conclusions Multimorbidity is common among pediatric cancer survivors. The current study identified 5 distinct comorbidity subgroups, all of which experienced high, yet differential, rates of health care use. The results of the current study highlight the complex health care needs of early survivors and provide evidence for the design of targeted survivorship services and interventions.
LTE2B: time-domain cross-technology emulation under LTE constraints

Conventional gateway solutions are limited in satisfying the demand for ubiquitous connections among heterogeneous wireless devices, e.g., wide-area and personal-area network devices, due to the deployment complexity, high cost, and the incurred extra traffic. Recent advances propose the physical layer cross-technology communication to address these issues. However, existing CTC techniques commonly emulate the target waveform in the frequency domain (FDE). Despite their success, these FDE based techniques inherently suffer from high quantization errors and are insufficient for IoT applications that require high communication reliability. To improve the emulation accuracy, we are the first to introduce the time-domain emulation (TDE) that significantly outperforms FDE techniques in reducing quantization errors and offers reliable emulation even with limited sources, e.g., low modulation schemes. To validate our idea, we propose LTE2B, the first TDE based CTC work that enables LTE devices (e.g., smartphones) to transmit data frames demodulatable by ZigBee and Bluetooth low energy (BLE) devices. We implement the LTE2B on commodity devices (Nexus 5X smartphone and CC2530/CC1350 ZigBee/BLE SoC) with only payload embedding by penetrating the extremely complicated LTE stack. Our extensive evaluation demonstrates that TDE outperforms FDE, while LTE2B can achieve a robust (> 99% accuracy), long distance (> 400m) CTC performance under a full range of wireless configurations including indoor/outdoor, mobility, and duty-cycle settings.
Imaging Guidance for Therapeutic Delivery: The Dawn of Neuroenergetics

Modern neurocritical care relies on ancillary diagnostic testing in the form of multimodal monitoring to address acute changes in the neurological homeostasis. Much of our armamentarium rests upon physiological and biochemical surrogates of organ or regional level metabolic activity, of which a great deal is invested at the metabolic–hemodynamic–hydrodynamic interface to rectify the traditional intermediaries of glucose consumption. Despite best efforts to detect cellular neuroenergetics, current modalities cannot appreciate the intricate coupling between astrocytes and neurons. Invasive monitoring is not without surgical complication, and noninvasive strategies do not provide an adequate spatial or temporal resolution. Without knowledge of the brain’s versatile behavior in specific metabolic states (glycolytic vs oxidative), clinical practice would lag behind laboratory empiricism. Noninvasive metabolic imaging represents a new hope in delineating cellular, nigh molecular level energy exchange to guide targeted management in a diverse array of neuropathology.
Association of acute vestibular/ocular motor screening scores to prolonged recovery in collegiate athletes following sport-related concussion

Introduction Researchers have yet to explore the association of acute (i.e., within 3 days) post-injury VOMS scores and length of time until clearance to return to play in collegiate athletes. Objective The purpose was to determine if individual Vestibular/Ocular Motor Screening (VOMS) component symptom scores (e.g., smooth pursuits, convergence, vestibular-ocular reflex) can predict clearance to return to activity from a sport-related concussion. Methods Pre-season demographic and medical history and post-injury VOMS testing were collected (n = 79) on collegiate student-athletes following concussion. Impaired vestibulo-ocular function post-injury scores (≥2) were compared to normal scores using survival analysis, with days to clearance to return to sport as the outcome. Results Abnormal scores on smooth pursuits (p =.026), horizontal saccades (p =.025), vertical saccades (p =.028), and convergence (p =.031) were associated with lower probability of clearance in comparison with normal scores. Any score ≥2 predicted significantly greater days to clearance for return to play (13.1 days; 95% CI: 11.9-14.3; p = .025) compared with athletes with no abnormal test scores (9.6 days; 95% CI: 7.2-12.1, P =.014). Discussion Post-injury symptoms with VOMS smooth pursuit, saccades, and convergence is associated with increased time-to-clearance for return to sport in collegiate athletes.
Clinical event debriefing: a review of approaches and objectives

PURPOSE OF REVIEW: This review explores four different approaches and clarifies objectives for debriefing after a clinical event in the emergency department. Psychological debriefing aims to prevent or reduce symptoms of traumatic stress and normalize recovery. Psychological first aid helps team members provide each other with pragmatic social support. Debriefing for simulation-based education promotes learning by team members. Quality improvement approaches and after action reviews focus on systems improvement. RECENT FINDINGS: Qualitative studies have begun to explore interactions between clinical staff after a significant clinical event. Clearer descriptions and measurements of quality improvements and the effect of clinical event debriefing on patient outcomes are appearing. An increasing number of studies describe melded, scripted approaches to the hot debrief. SUMMARY: Clinical staff have consistently indicated they value debriefing after a significant clinical event. Differing objectives from different approaches have translated into a wide variety of methods and a lack of clarity about relevant outcomes to measure. Recent descriptions of scripted approaches may clarify these objectives and pave the way for measuring relevant outcomes that demonstrate the effectiveness of and find the place for debriefing in the emergency department.
6 – Research Types

Publisher Summary This chapter provides an overview of each of the main types of research, namely, historical, descriptive, and experimental. It discusses the principles of the types most commonly encountered in the social and behavioral sciences, such as characteristics, subtypes, and problems (pitfalls and errors). It describes and compares special procedures for data collection and special procedures for data analysis associated with each type. The goal is to orient to make an efficient use of more detailed reference material. Every social science discipline has manuals of methodology; excellent manuals are available for specific topics such as survey methods, interviewing, and questionnaire construction. The chapter presents PERT-network sequences for planning the steps in descriptive and experimental studies. It explains the classification scheme by incorporating the goal of the study in addition to the nature of evidence and the possibility of control. The chapter, through a diagram, explains key characteristics of the problem so as to help you choose a research design. It is in the form of a flow diagram and works like a decision-tree even though the underlying taxonomy is neither perfectly exhaustive nor perfectly exclusive.
Species biodiversity and distribution of seagrass beds in several coastal areas of central Vietnam

Abstract Seagrasses provide habitat and abundant food supplies for numerous marine species and seagrass ecosystems play a vital role in protecting the coast from erosion. There were numerous seagrass studies in Vietnam, however, while these studies provide information on specific studied places, there is a lack of comparison between studies for providing a broad picture of the overall seagrass ecosystem along the coast of Central Vietnam. Hence, this study of species diversity and distribution of seagrasses along the coast of Central Vietnam was conducted to provide comparative data, which is highly valuable for the proper exploitation, management, and sustainable development of seagrass resources in Central Vietnam. This study identified eight species of seagrass belonging to two families—Hydrocharitaceae and Cymodoceaceae—in the waters around several islands in Central Vietnam. Among them Halophila beccarii in the Cua Dai estuary was listed in the Red List of Threatened Species by the International Union for Conservation of Nature (IUCN) (2017)—at risk of global extinction. The results revealed that the seagrass beds in several coastal areas of Central Vietnam have diminished over time with respect to the number of species and their distribution with causes attributed to anthropogenic activities. The seagrass canopy coverage ranged from 5 to 100% (57 ± 36.20%) near several coastal islands of Central Vietnam. The majority of seagrass is distributed in both intertidal and subtidal zones Our findings suggest that water quality and important sedimentary processes vital to ecosystem health need to be assessed throughout the coastal region.
A mathematical model and inference method for bacterial colonization in hospital units applied to active surveillance data for carbapenem-resistant enterobacteriaceae.

Widespread use of antibiotics has resulted in an increase in antimicrobial-resistant microorganisms. Although not all bacterial contact results in infection, patients can become asymptomatically colonized, increasing the risk of infection and pathogen transmission. Consequently, many institutions have begun active surveillance, but in non-research settings, the resulting data are often incomplete and may include non-random testing, making conventional epidemiological analysis problematic. We describe a mathematical model and inference method for in-hospital bacterial colonization and transmission of carbapenem-resistant Enterobacteriaceae that is tailored for analysis of active surveillance data with incomplete observations. The model and inference method make use of the full detailed state of the hospital unit, which takes into account the colonization status of each individual in the unit and not only the number of colonized patients at any given time. The inference method computes the exact likelihood of all possible histories consistent with partial observations (despite the exponential increase in possible states that can make likelihood calculation intractable for large hospital units), includes techniques to improve computational efficiency, is tested by computer simulation, and is applied to active surveillance data from a 13-bed rehabilitation unit in New York City. The inference method for exact likelihood calculation is applicable to other Markov models incorporating incomplete observations. The parameters that we identify are the patient–patient transmission rate, pre-existing colonization probability, and prior-to-new-patient transmission probability. Besides identifying the parameters, we predict the effects on the total prevalence (0.07 of the total colonized patient-days) of changing the parameters and estimate the increase in total prevalence attributable to patient–patient transmission (0.02) above the baseline pre-existing colonization (0.05). Simulations with a colonized versus uncolonized long-stay patient had 44% higher total prevalence, suggesting that the long-stay patient may have been a reservoir of transmission. High-priority interventions may include isolation of incoming colonized patients and repeated screening of long-stay patients.
A Qualitative System Dynamics Model for Effects of Workplace Violence and Clinician Burnout on Agitation Management in the Emergency Department

Introduction Over 1.7 million episodes of agitation occur annually across the United States in emergency departments (EDs), some of which lead to workplace assaults on clinicians and require invasive methods like physical restraints to maintain staff and patient safety. Recent studies demonstrated that experiences of workplace violence lead to symptoms of burnout, which may impact future decisions regarding use of physical restraints on agitated patients. To capture the dynamic interactions between clinicians and agitated patients under their care, we applied qualitative system dynamics methods to develop a model that describes causal feedback mechanisms of clinician burnout and the use of physical restraints to manage agitation. Methods We convened an interprofessional panel of clinician stakeholders and agitation experts for a series of model building sessions to develop the current model. The panel derived the final version of our model over ten sessions of iterative refinement and modification, each lasting approximately three to four hours. We incorporated findings from prior studies on agitation and burnout as a result of workplace violence, identifying interpersonal and psychological factors likely to influence our outcomes of interest to form the basis of our model. Results The final model resulted in five main sets of feedback loops that describe key narratives regarding the relationship between clinician burnout and agitated patients becoming physically restrained: (1) use of restraints decreases agitation and risk of assault, leading to increased perceptions of safety and decreasing use of restraints in a balancing feedback loop which stabilizes the system; (2) clinician stress leads to a perception of decreased safety and lower threshold to restrain, causing more stress in a negatively reinforcing loop; (3) clinician burnout leads to a decreased perception of colleague support which leads to more burnout in a negatively reinforcing loop; (4) clinician burnout leads to negative perceptions of patient intent during agitation, thus lowering threshold to restrain and leading to higher task load, more likelihood of workplace assaults, and higher burnout in a negatively reinforcing loop; and (5) mutual trust between clinicians causes increased perceptions of safety and improved team control, leading to decreased clinician stress and further increased mutual trust in a positively reinforcing loop. Conclusions Our system dynamics approach led to the development of a robust qualitative model that illustrates a number of important feedback cycles that underly the relationships between clinician experiences of workplace violence, stress and burnout, and impact on decisions to physically restrain agitated patients. This work identifies potential opportunities at multiple targets to break negatively reinforcing cycles and support positive influences on safety for both clinicians and patients in the face of physical danger.
Validity of Self-Reported Hepatitis C Virus Status Among Criminal Justice-Involved Persons Living With HIV.

The prevalence of HIV/hepatitis C virus (HCV) coinfection among justice-involved persons is high. The validity of self-reported HCV status in this population has important public health implication...
Surgeon Volume And Established Hospital Peri-operative Mortality Rate Together Predict Superior Outcomes After Open AAA Repair

ABSTRACT BACKGROUND In 2018, the SVS published hospital volume guidelines for elective open abdominal aortic aneurysm (AAA) repair, recommending elective open surgical repair for AAA be performed at centers with an annual volume of at least 10 open aortic operations of any type and a documented perioperative mortality of 5% or less. Recent work suggests a yearly surgeon volume of ≥7 open aortic cases for improved outcomes. The objective of this study is to assess the importance of hospital volume and surgeon volume at these cut points in predicting 1-year mortality after OSR for AAA. METHODS We evaluated patients undergoing elective open AAA repair using The New York Statewide Planning and Research Cooperative System database from 2003 to 2014. The effect of the SVS guidelines on postoperative mortality and complications was evaluated. Confounding between hospital and surgeon volume was identified using mixed-effects multivariate cox proportional hazards analysis. The effect of interactions between hospital volume, established hospital perioperative survival, and surgeon volume on post-operative outcomes was investigated. RESULTS The cohort consisted of 7,594 elective open AAA repairs performed by 542 surgeons in 137 hospitals over the 12 years. Analysis of the 2018 guidelines using the SPARCS database resulted in 1-year and 30-day mortality rates of 9.2% (8.3–10.1) and 3.5% (2.9-4.1) for centers that were within the guidelines and 13.6% (12.5–14.7) and 6.9% (6.1-7.8) for those that were outside the guidelines, respectively (both p CONCLUSIONS These data demonstrate centers that meet the SVS AAA volume guidelines are associated with improved 1-year and 30-day all-cause survival; however, are confounded by surgeon volume. Surgeon open aortic volume ≥7 and established hospital perioperative mortality of ≤5% each independently predict 1-year survival after open AAA repair, while hospital volume is less important. Surgeons with an annual volume of at least 7 open aortic operations of any type should perform elective open AAA repair at centers with a documented perioperative mortality of 5% or less.
Elastic Stability of Tapered Beam-Columns

The behavior of axially loaded columns and beam-columns of uniform cross sections has been extensively investigated in both the elastic and inelastic ranges. In various practical situations, however, the use of tapered members, or wedge beams, is economically advantageous. The elastic stability of axially loaded tapered columns has been studied analytically by several investigators. The determination of the initial yield load for tapered beam-columns has also been investigated. In addition, an experimental investigation of the elastic stability of tapered beam-columns has been reported.
Operations to Replace or Bypass the Esophagus: Colon or Jejunum Interposition; Transhiatal Esophagectomy with Gastric Pull-Up

Using the colon (or jejunum) to replace resected segment of the esophagus permits the surgeon to preserve intact a functioning stomach. Performing the cologastric anastomosis 10 cm down from the gastric cardia will generally minimize gastrocolic reflux. Achieving a sufficient length of viable colon is, with rare exceptions, feasible. One drawback to using the colon as a substitute esophagus is the risk of impairing the venous blood flow either by injuring the veins in the colon mesentery or impairing venous return by leaving an inadequate aperture in the diaphragm or at the apex of the thorax for the colon and its mesentery. Under these conditions venous infarction can occur. Following careful surgery, this complication should be quite rare. Belsey experienced one colon infarct in 92 left colon interposition operations. This complication appears to be more common when the right colon is used as opposed to the left colon (Wilkins).
Opening Up or Shutting Down? The Effects of Multiple Identities on Problem Solving

Across three studies, I investigate the distinct effects of multiple identity conflict and enhancement within people on two crucial aspects of resolving problems with others: integrative behavior and openness. The results of two studies support the hypotheses that multiple identity conflict is negatively related to integrative thinking while multiple identity enhancement is positively related to attitudes of openness to others. In a third study, I conducted an interpersonal dyadic negotiation experiment with business school students and found that, as predicted, these effects replicated and extended to integrative outcomes and open behaviors. This research shows that there are both harmful and helpful effects of multiple identities on interpersonal problem solving depending on whether those identities are enhancing or conflicting: multiple identity conflict shuts down integrative thought and behavior and multiple identity enhancement opens us up to other people.
Block-switched networks: a new paradigm for wireless transport

TCP has well-known problems over multi-hop wireless networks as it conflates congestion and loss, performs poorly over time-varying and lossy links, and is fragile in the presence of route changes and disconnections. Our contribution is a clean-slate design and implementation of a wireless transport protocol, Hop, that uses reliable per-hop block transfer as a building block. Hop is 1) fast, because it eliminates many sources of overhead as well as noisy end-to-end rate control, 2) robust to partitions and route changes because of hop-by-hop control as well as in-network caching, and 3) simple, because it obviates complex end-to-end rate control as well as complex interactions between the transport and link layers. Our experiments over a 20-node multi-hop mesh network show that Hop is dramatically more efficient, achieving better fairness, throughput, delay, and robustness to partitions over several alternate protocols, including gains of more than an order of magnitude in median throughput.
Serial rapid assay of total urinary estrogens in pregnancy.

Abstract The results of serial 24 hour urine total estrogen determinations in a group of normal pregnancies with a previously reported rapid assay for total estrogen are presented. This method provides clinicians with a means of serially assessing fetoplacental function at reasonable expense and with rapid availability of results. The significance of routine serial estrogen determinations with simultaneous reporting of total urine volume and creatinine content is emphasized.
Acne (Vulgaris and Rosacea)

Abstract The American Academy of Dermatology defines acne as “the most common skin condition in the United States”. Acne vulgaris normally begins with puberty, but adult cases are on the increase. It is an inflammatory disorder of the pilosebaceous units of the skin associated with the bacterium Propionibacterium acnes. Acne rosacea usually begins later in life, and is characterized by skin erythema, telangiectasia, papules, and pustules of the face. The cause of rosacea is presently unknown. If severe, it can cause a bulbous deformity of the nose (rhinophyma). Sufferers of either form of acne may experience considerable psychological and social dysfunction.
Four-Manifolds, Curvature Bounds, and Convex Geometry

Seiberg—Witten theory leads to a remarkable family of curvature estimates governing the Riemannian geometry of compact 4-manifolds. This chapter describes a more transparent and user-friendly repackaging of these estimates, formulated in terms of the convex hull of the set of monopole classes. New results are then obtained concerning the boundary cases of the reformulated curvature estimates.
Digital PID controller tuning using prefiltered ARX estimation

The use of prefiltered ARX (autoregressive with exogenous input) estimation to obtain reduced-order models that satisfy the Prett-Garcia (1988) digital PID (proportional plus integral plus derivative) tuning rules is described. The design of the prefilter is performed systematically using the engineer's desired control requirements and the setpoint/disturbance characteristics of the problem. The benefits of this method are shown for a fourth-order system. >
Modular avionics: its impact on communication, navigation, and identification (CNI)

The impact of modular integrated avionics on radio communication, navigation, and identification (CNI) systems is discussed from several viewpoints: (1) system design, (2) specifications, (3) cost, (4) market effects, and (5) supportability. It is concluded that system designs, market practices, and maintenance and support will appreciably change, resulting in enhanced mission effectiveness at optimum costs to the US Dept. of Defense. >
Programming models and system software for future high-end computing systems: work-in-progress

Future high-end computers which promise very high performance require sophisticated program execution models and languages in order to deal with very high latencies across the memory hierarchy and to exploit massive parallelism. This paper presents our progress in an ongoing research toward this goal. Specifically we develop a suitable program execution model, a high-level programming notation which shields the application developer from the complexities of the architecture, and a compiler and runtime system based on the underlying models. In particular, we propose fine-grain multithreading and thread percolation as key components of our program execution model. We investigate implementing these models and systems on novel architectures such as the HTMT architecture and IBM's Blue Gene. Also, we report early performance prediction of thread percolation and its impact on execution time.
Navigating vehicles through an unstructured environment with sonar

A procedure to navigate a vehicle from a source to a destination through an unstructured environment using only a sonar sensor is described. The environment considered is a two-dimensional floor plan, consisting of line segments of arbitrary size that is extended into the third dimension. To ensure that a sonar-guided vehicle does not collide with an obstacle, it is necessary to consider an obstacle that produce the weakest echoes and determine the conditions under which these obstacles can be detected. In this environment, the smallest echo is produced by the line that defines the boundary between the two planes, or the edge; and distant edges become invisible. This physical principle then becomes the basis for the navigation strategy, indicating the necessary scanning pattern and maximum step size that guarantee that no collision will occur. The approach is illustrated with results produced by a vehicular robot equipped with a Polaroid sensor. A representative floor plan and the automatically determined path are shown; a blind alley was included to observe the behavior of the algorithm. >
MEASUREMENT OF THE STORED ENERGY IN X-RAYED SODIUM CHLORIDE

The stored energy in sodium chloride crystals irradiated with x rays at room temperature was measured by dissolving the crystals in water and measuring the temperature changes. In the range of $F$-center densities between 2.5\ifmmode\times\else\texttimes\fi{}${10}^{17}$ and 6.5\ifmmode\times\else\texttimes\fi{}${10}^{17}$ per ${\mathrm{cm}}^{3}$, the curve of stored energy versus $F$-center density was a straight line, whose extrapolation did not intersect the origin. Quantitative interpretation of the slope of this line is difficult because of lack of knowledge about the chemical nature of a solution of irradiated NaCl. According to the interpretation favored in this article, the stored energy associated with one $F$ center in this coloration range is 9.2\ifmmode\pm\else\textpm\fi{}0.3 eV. This value for the stored energy is in good agreement with a simple energy level scheme involving the $F$ center, so that if there are any defects produced by x rays at room temperature which have not yet been discovered, they probably do not involve much stored energy. Crystals which have been irradiated and then thermally bleached no longer have any stored energy, from which we conclude that chlorine does not leave the crystals during irradiation or subsequent heating.
Preconcentration and Assay of Radionuclides with Self Assembled Monolayers on Mesoporous Supports

An analytical system is suggested to separate a number of elements of the Periodic Table in a hydrogen or oxygen stream at temperatures up to 1400 °C. High temperature chemical filters are used to separate volatile products. The approach has demonstrated its efficiency in a number of examples of carrier-free isotope production from targets irradiated at an accelerator: 109 Cd from In; 22 Na from Al; 72 Se from GaAs; 188 Pt, 183 Re, 185 Os and 201 Tl from Pb or Bi; separation of Po from Pb and Bi, etc. Another application of high temperature chemical sublimation of elements and oxides was realized in activation analysis of noble metals in various ores and samples.