cssi/SciSciGPT-SciSciNet huggingface dataset:
Toward a Story Powerful Enough to Reduce Health Inequities in Indian Country The Case of Diabetes

What, within Indigenous modes of health and wellness, can structure a story powerful enough to reduce health inequities in Indian Country? Health inequities in Indian Country have resisted improvements despite considerable effort. Many inequities have stabilized with a few inequities worsening. This article seeks to document the movement of stories for health inequities, focusing in particular on the online presence of wellness programs for diabetes in American Indian communities. Stories, health care providers, those who suffer with diabetes, families, bodies, communities, limbs, tribes, insulin, and traditional medicines all act within a larger narrative that envisions Indian Country without the ongoing devastation of diabetes. The practice of storytelling, as evidenced in each of the wellness programs, itself is an intervention in a health care system that would rather uplift the physicians’ stories of the patients than the patients’ stories of themselves. By considering websites of multiple wellness p...
AB032. A systematic review (meta-analysis): low energy shock wave improves erectile function

Background As a novel therapeutic method for erectile dysfunction (ED), the Low Energy Shock Wave (LESW) has been applied in the clinical setting recently. We feel that a summary of the current literature and a systematic review to evaluate the therapeutic efficacy of LESW for ED would be helpful for physicians who are interested in using this modality to treat patients.
Analyzing the Effect of Team Structure on Team Performance: An Experimental and Computational Approach

This paper investigates how team structure impacts team information processing and how this affects team resilience to change. Teams in three different subgrouping structures: homogeneous, heterogeneous, or no-clustering, were instructed to make decisions in which they had to evaluate different companies and pick the best one. Each member was told to evaluate the companies in a different way, creating teams with diverse perspectives. Partway through the experiment the problem evaluation criteria changed, but teams were not informed of the change, only whether their choice was correct. Teams with homogeneous-clustering were less capable than the other two types of teams in making use of multiple preferences and in dealing with changes. A similar effect was also found in computational simulations built from a PDP model. We suggest that heterogeneous-clustering can weaken members’ ownership and confirmation biases while no-clustering ensures a free flow of information, with both able to enhance team performance.
Seminoma in an adult with acute lymphocytic leukemia.

AbstractWe present a unique case of a seminoma in an adult with acute lymphocytic leukemia in clinical remission. As survival improves with modern multimodal chemotherapy testicular relapse of acute lymphocytic leukemia is becoming more common. A histopathological diagnosis is needed to initiate appropriate local and systemic therapy. In children a transscrotal approach for testis biopsy is used. However, the approach in adults with presumed testicular relapse has not been addressed. The risk factors of testicular relapse, the use of ultrasound in the diagnosis and the need to consider the classic differential diagnosis of a testicular mass are discussed.
Industrial biomanufacturing: The future of chemical production

Producing mass quantities of chemicals has its roots in the industrial revolution. But industrial synthesis leads to sizeable sustainability and socioeconomic challenges. The rapid advances in biotechnology suggest that biological manufacturing may soon be a feasible alternative, but can it produce chemicals at scale? Clomburg et al. review the progress made in industrial biomanufacturing, including the tradeoffs between highly tunable biocatalysts and units of scale. The biological conversion of single-carbon compounds such as methane, for example, has served as a testbed for more sustainable, decentralized production of desirable compounds. Science , this issue p. [10.1126/science.aag0804][1] [1]: /lookup/doi/10.1126/science.aag0804
Fault tolerance with bare ancillary qubits for a [[7,1,3]] code

We present a $[[7,1,3]]$ quantum error-correcting code that is able to achieve fault-tolerant syndrome measurement using one ancillary qubit per stabilizer for an error model of independent single-qubit Pauli errors. All single-qubit Pauli errors on the ancillary qubits propagate to form exclusively correctable errors on the data qubits. The situation changes for error models with two-qubit Pauli errors. We compare the level-1 logical error rates under two noise models: the standard Pauli symmetric depolarizing error model and an anisotropic error model. The anisotropic model is motivated by control errors on two-qubit gates commonly applied to trapped ion qubits. We find that one ancillary qubit per syndrome measurement is sufficient for fault-tolerance for the anisotropic error, but is not sufficient for the standard depolarizing errors. We then show how to achieve fault tolerance for the standard depolarizing errors by adding flag qubits to check for errors on select ancillary qubits. Our results on this $[[7,1,3]]$ code demonstrates how physically motivated noise models may simplify fault-tolerant protocols.
Curtailing succession: Removing conifers enhances understory light and growth of young aspen in mixed stands around Lake Tahoe, California and Nevada, USA

Abstract Aspen is a keystone species that is relatively rare in the Sierra Nevada Mountains and is undergoing succession to conifers in the absence of disturbance. In the presence of more conifers, recruitment of young aspen to replace aging overstory aspen is failing and diverse understory plant communities are being lost. We studied vegetation attributes and understory light in nine aspen-conifer stands in the Lake Tahoe Basin in California and Nevada, USA. Within each stand we measured and mapped trees in a one-hectare study area and collected 27–30 hemispherical canopy images on a grid that were used to estimate forest canopy variables and the amount of light reaching the understory. We also measured percent cover of herbaceous vegetation on the same sample grid. After restoration treatments cut smaller conifer trees at six of the nine sites, we repeated canopy images and began monitoring the growth of young aspen adjacent to sample grid points. Less light was reaching the understory beneath areas of forest canopy dominated by true firs. Understory light was enhanced by removal of conifers (pine and fir species). Stand density and species composition of trees surrounding a grid point where each hemispherical image was taken were useful predictors of understory light and forest canopy variables, herbaceous vegetation cover, and the morphology and growth of young aspen. Less herbaceous vegetation was found in the vicinity of true firs and pines, particularly in areas with less light being transmitted to the forest floor. In areas where the overstory was pure aspen, herbaceous vegetation cover remained high across the range of understory light levels measured. Greater conifer removal treatment intensity, in terms of proportion of stand density cut, enhanced crown ratio and growth of young aspen. Height and diameter increment of young aspen was negatively impacted by the presence of true fir trees in the vicinity. If the objectives of forest management include promoting understory vegetation cover or vigorous aspen regeneration, then removing conifers (especially true firs) from aspen-conifer stands appears to be a viable management tool; using such an approach should focus on removing as many conifers as possible within approximately 8–11 m of areas where an enhancement of understory light, herbaceous vegetation, and the growth and vigor of young aspen is desired.
Sarcoidosis Presenting as Bilateral Vocal Fold Immobility

Bilateral true vocal fold paralysis is rarely attributable to inflammatory diseases. Sarcoidosis is a rare but important etiology of bilateral true vocal fold paralysis by compressive lymphadenopathy, granulomatous infiltration, and neural involvement. We describe the first reported case of sarcoidosis presenting as bilateral vocal fold immobility caused by direct fixation by granulomatous infiltration severe enough to necessitate tracheostomy insertion. In addition, we discuss the presentation, the pathophysiology, and the treatment of this disease with a review of the literature of previously reported cases of sarcoidosis-related vocal fold immobility. Sarcoidosis should therefore be an important consideration for the otolaryngologist's differential diagnosis of true vocal fold immobility.
A 3D finite element modelling of crystalline anisotropy in rolling contact fatigue

Abstract Rolling contact fatigue (RCF) is one of the primary modes of failure in bearings and in this study it is hypothesized and demonstrated that RCF is strongly influenced by inhomogeneity in polycrystalline material microstructure. This paper presents a three-dimensional modeling approach to include the effects of microstructure topology and material anisotropy in a polycrystalline microstructural bearing steel subject to RCF loading. A randomly generated 3D Voronoi tessellation is used to represent the microstructural topology of the material. A cubic material definition with random spatial orientation is specified for the material grains to simulate the polycrystalline anisotropy. The size of the RVE was chosen such that it represented the macroscopic linear elastic material properties of a polycrystalline aggregate. The semi-infinite domain is then subjected to a moving Hertzian pressure to simulate a load cycle. Due to inhomogeneity in the polycrystalline material local stress risers occur at the grain boundaries, however, in general, the locations of the maximum shear stresses compare well to the experimental RCF results readily available in literature. Elemental shear stresses averaging scheme was employed to illustrate that the finite element model is mesh independent. The estimated fatigue life scatter obtained from the inhomogeneous polycrystalline material model corroborates well with the fatigue life scatter obtained from the RCF experiments.
Efficient Local Search for Euclidean Path-Difference Median Trees

Synthesizing large-scale phylogenetic trees is a fundamental problem in evolutionary biology. Median tree problems have evolved as a powerful tool to reconstruct such trees. Such problems seek a median tree for a given collection of input trees under some problem-specific tree distance. There has been an increased interest in the median tree problem for the classical path-difference distance between trees. While this problem is NP-hard, standard local search heuristics have been described that are based on solving a local search problem exactly. For a more effective heuristic we devise a time efficient algorithm for the local search problem that improves on the best-known solution by a factor of $n$n, where $n$n is the size of the input trees. Furthermore, we introduce a novel hybrid version of the standard local search that is exploiting our new algorithm for a more refined heuristic search. Finally, we demonstrate the performance of our hybrid heuristic in a comparative study with other commonly used methods that synthesize species trees using published empirical data sets.
Food Security Among Rural Appalachian Families with School-Aged Children:

Abstract Urban areas are often cited as having increased levels of food insecurity; however, poor rural areas may also be prone. The purposes of this pilot study approved by the Institutional Review Board were to assess: 1) the degree of food security during the academic year among rural Appalachian families with school-aged children; 2) if food assistance program participation influenced food security; and 3) if game intake influenced food security. Families intending to participate in a summer educational enrichment/food service program were chosen as subjects. A 32-item survey (6th grade reading level, SMOG readability formula) was developed using the USDA Food Security Core Module (CM). Of the 350 surveys administered to parents/caregivers, 252 (72% response rate) were returned and analyzed (SPSS 8.0, Chicago, EL, 1998). Food insecurity was experienced by 80 families (32%), with 46 (18%), 18 (7%), and 16 (6%) being food insecure without hunger, with moderate hunger, and with severe hunger, respectively. Families participated in WIC (n=47, 19%), food stamps (n-58,23%), food banks (n=l 1,4%), school lunch program (n=122, 48%), school breakfast program (n=84, 33%), and other programs (n=2, 1%). Food security increased as participation in the number of food assistance programs increased (r=0.33, p 2 =0.44, p
My prolonged collaboration with Ray Guillery

My active collaboration with Ray Guillery started in 1968, when he was a Full Professor at the University of Wisconsin and I was a graduate student at the University of Pennsylvania. The collaboration lasted almost 50 years with virtually no breaks. Among the ideas we proposed are that glutamatergic pathways in thalamus and cortex can be classified into drivers and modulators; that many thalamic nuclei could be classified as higher order, meaning that they receive driving input from layer 5 of cortex and participate in cortico-thalamocortical circuits; and that much of the information relayed by thalamus serves as an efference copy for motor commands initiated by cortex.
The influence of temperature stress on the physiology of the Atlantic surfclam, Spisula solidissima

Abstract Atlantic surfclam populations have significantly declined in state and federal waters from the south shore of Long Island, New York to the Delmarva Peninsula since the early 2000s. Previous studies have demonstrated that surfclams in this geographic range show signs of physiological stress, suggested to be a result of increasing ocean temperatures. In this study, we examined the effect of 2 temperature regimes (19 °C and 23 °C) on surfclam physiology. These temperatures were chosen because they represent maximal (23 °C) and minimal (19 °C) temperatures prevailing in New York clamming areas during summer. Results demonstrated enhanced energy metabolism and significant reductions in filtration rate, scope for growth, and immune functions in clams exposed to the warmer temperature treatment. Although net energy gains remained positive in both treatments under our experimental conditions, the findings suggest that temperature stress is involved in the recent observations of surfclams in poor condition. The impact of elevated temperatures on phytoplankton quantity/quality and other environmental variables in combination with the direct impact on surfclam filtration and metabolic rates could lead to a negative energy balance. While some uncertainties remain about population-scale impacts of overall warming trends, we fear that future increases in temperature may lead to the collapse of the Atlantic surfclam between New York and Virginia, especially within inshore regions.
The Facts of Tropes

Kevin Mulligan’s defense of a variant of trope theory is critically examined. It is argued that his account employing tropes, as opposed to facts, in the role of grounding the truths of monadic and relational predications is problematic and not a viable alternative to an account employing facts. A key point involves Mulligan’s appeal to the concept expressed by the phrase “because of” in his rejection of facts as grounds of truth and his reliance on the Aristotelian notion of a nature. Further problems with trope doctrines are explored in connection with relations and causality as well as related arguments and views by other figures who have addressed the problems of predication and the status of facts.
Quantifying security and privacy in Internet of Things solutions

As the Internet of things continues to mature, there has been a wide and rapid adoption of Internet of things solutions in many domains. However, the security and privacy of these solutions are often underrated. The lack of security and privacy in the solutions can lead to catastrophic results, especially in sensitive domains like healthcare. Therefore, it is imperative to ensure their security and privacy. Stakeholders often find themselves unguided when assessing the security and privacy of the solutions. This paper proposes a framework to quantitatively assess and compare the security and privacy in Internet of things solutions using Analytic Hierarchy Process. It also provides in-depth security and privacy assessment criteria to enhance security and privacy in the Internet of things solutions. This work aims to fill the gap between consumers and providers by promoting transparency and increasing the security awareness.
The diversity of tectonic modes and thoughts about transitions between them

Plate tectonics is a particular mode of tectonic activity that characterizes the present-day Earth. It is directly linked to not only tectonic deformation but also magmatic/volcanic activity and all aspects of the rock cycle. Other terrestrial planets in our Solar System do not operate in a plate tectonic mode but do have volcanic constructs and signs of tectonic deformation. This indicates the existence of tectonic modes different from plate tectonics. This article discusses the defining features of plate tectonics and reviews the range of tectonic modes that have been proposed for terrestrial planets to date. A categorization of tectonic modes relates to the issue of when plate tectonics initiated on Earth as it provides insights into possible pre-plate tectonic behaviour. The final focus of this contribution relates to transitions between tectonic modes. Different transition scenarios are discussed. One follows classic ideas of regime transitions in which boundaries between tectonic modes are determined by the physical and chemical properties of a planet. The other considers the potential that variations in temporal evolution can introduce contingencies that have a significant effect on tectonic transitions. The latter scenario allows for the existence of multiple stable tectonic modes under the same physical/chemical conditions. The different transition potentials imply different interpretations regarding the type of variable that the tectonic mode of a planet represents. Under the classic regime transition view, the tectonic mode of a planet is a state variable (akin to temperature). Under the multiple stable modes view, the tectonic mode of a planet is a process variable. That is, something that flows through the system (akin to heat). The different implications that follow are discussed as they relate to the questions of when did plate tectonics initiate on Earth and why does Earth have plate tectonics. This article is part of a discussion meeting issue ‘Earth dynamics and the development of plate tectonics’.
Effects of HIV Infection, methamphetamine dependence and age on cortical thickness, area and volume.

Abstract Objective This study examined the effects of HIV infection, methamphetamine dependence and their interaction on cortical thickness, area and volume, as well as the potential interactive effects on cortical morphometry of HIV and methamphetamine with age. Method T1-weighted structural images were obtained on a 3.0T General Electric MR750 scanner. Freesurfer v5.3.0 was used to derive cortical thickness, area and volume measures in thirty-four regions based on Desikan-Killiany atlas labels. Results Following correction for multiple statistical tests, HIV diagnosis was not significantly related to cortical thickness or area in any ROI, although smaller global cortical area and volume were seen in those with lower nadir CD4 count. HIV diagnosis, nevertheless, was associated with smaller mean cortical volumes in rostral middle frontal gyrus and in the inferior and superior parietal lobes. Methamphetamine dependence was significantly associated with thinner cortex especially in posterior cingulate gyrus, but was not associated with cortical area or volume following correction for multiple statistical tests. We found little evidence that methamphetamine dependence moderated differences in cortical area, volume or thickness for any ROI in the HIV seropositive group. Interactions with age revealed that HIV diagnosis attenuated the degree of age-related cortical thinning seen in non-infected individuals; intercepts indicated that young HIV seropositive individuals had thinner cortex than non-infected peers. Conclusions Methamphetamine dependence does not appear to potentiate a reduction of cortical area, volume or thickness in HIV seropositive individuals. The finding of thinner cortex in young HIV seropositive individuals and the association between CD4 nadir and global cortical area and volume argue for prioritizing early antiretroviral treatment.
SAT Does Not Spell Success: How Non-Cognitive Factors Can Explain Variance in the GPA of Undergraduate Engineering and Computer Science Students

This work-in-progress research paper uses multiple regression of both cognitive and non-cognitive factors to model current GPA of engineering and computer science students. High school GPA and ACT/SAT scores are among the most common scores used as admission criteria, which result in a relatively homogeneous engineering population. Prior research, however, shows that these scores do not account for the variance in GPA once these students start undergraduate studies. In this work, we explore how students’ cognitive (e.g., study skills, test performance, regulatory behaviors, etc.) and non-cognitive factors (e.g., identity, motivation, personality, etc.) predict student success in their engineering pathways. The data for this initial study comes from a pilot survey, deployed in the summer of 2017, of 490 engineering and computing students from two large, public institutions, one on the West Coast, the other in the Midwest. We used multiple linear regression to control for demographic variables while examining the predictive value of particular cognitive and non-cognitive factors for student academic achievement (i.e., GPA) in university. Our analysis shows, not surprisingly, that standardized test scores only explain a small portion of the variance of undergraduate GPA. Including non-cognitive and affective factors into a regression model produced a marked increase in the explained variance. Our work is novel in examining a constellation of possible factors that predict undergraduate student GPA, by combining both cognitive and non-cognitive factors as predictors. This analysis begins to unpack particular factors that have potential to predict GPA of engineering and computer science students.
Simultaneous Unbalanced Shared Local Oscillator Heterodyne Interferometry (SUSHI) for high SNR, minimally destructive dispersive detection of time-dependent atomic spins

We demonstrate „Simultaneous Unbalanced Shared Local Oscillator Heterodyne Interferometry (SUSHI),“ a new method for minimally destructive, high SNR dispersive detection of atomic spins. In SUSHI, technical noise due to phase, amplitude, and frequency fluctuations of the probe laser is strongly rejected (i) for any mean phase bias between the interferometer arms, (ii) without the use of piezo actuated mirrors, and (iii) without signal balancing. We experimentally demonstrate an technical noise limited phase sensitivity of 37 nrad/rtHz for a measurement bandwidth of 60 Hz to 8 kHz using a 230 uW probe, and stay within 3 dB of the standard quantum limit as probe power is reduced by more than 5 orders of magnitude to as low as 650 pW. SUSHI is therefore well suited to performing QND measurements for preparing spin squeezed states and for high SNR, truly continuous observations of ground-state Rabi flopping in cold atom ensembles.
Thermal Design and Analysis for the Cryogenic MIDAS Experiment

The Materials In Devices As Superconductors (MIDAS) spaceflight experiment is a NASA payload which launched in September 1996 on the Shuttle, and was transferred to the Mir Space Station for several months of operation. MIDAS was developed and built at NASA Langley Research Center (LaRC). The primary objective of the experiment was to determine the effects of microgravity and spaceflight on the electrical properties of high-temperature superconductive (HTS) materials. The thermal challenge on MIDAS was to maintain the superconductive specimens at or below 80 K for the entire operation of the experiment, including all ground testing and 90 days of spaceflight operation. Cooling was provided by a small tactical cryocooler. The superconductive specimens and the coldfinger of the cryocooler were mounted in a vacuum chamber, with vacuum levels maintained by an ion pump. The entire experiment was mounted for operation in a stowage locker inside Mir, with the only heat dissipation capability provided by a cooling fan exhausting to the habitable compartment. The thermal environment on Mir can potentially vary over the range 5 to 40 Degrees C; this was the range used in testing, and this wide range adds to the difficulty in managing the power dissipated from the experiment''s active components. Many issues in the thermal design are discussed, including: thermal isolation methods for the cryogenic samples; design for cooling to cryogenic temperatures; cryogenic epoxy bonds; management of ambient temperature components'' self-heating; and fan cooling of the enclosed locker. Results of the design are also considered, including the thermal gradients across the HTS samples and cryogenic thermal strap, electronics and thermal sensor cryogenic performance, and differences between ground and flight performance. Modeling was performed in both SINDA-85 and MSC/PATRAN (with direct geometry import from the CAD design tool Pro/Engineer). Advantages of both types of models are discussed. Correlation of several models to ground testing and flight data (where available) is presented. Both SINDA and PATRAN models predicted the actual thermal performance of the experiment well, even without post-flight correlation adjustments of the models.
P257 Afternoon TEA-ching – to TEAch or not to TEAch

Nicola Hanlon, Clinical Educational Facilitator & Karen Cunningham Clinical Nurse Manager 2 , SMC/Renal unit TSCUH. Background Workforce deficiencies and variations within the health care system have called for a significant evaluation on how nurses are trained to deal with challenges within the health care setting. Despite these changes nurses must advance and develop in order to provide practice that is safe, reliable , of high quality and evidence based. An effective clinical learning environment is crucial for the development of specific clinical skills and competencies through theoretical, practical knowledge and understanding (Chuan & Barnett 2012, Cibulka 2011,Roxburgh et al 2008, Heath 2002). In order to improve current practices, reliable inter professional collaboration is essential. Health professionals from all backgrounds should work together as a team in order to improve patient outcomes, provide a standard of care that is evidence based leading to an enhancement of the quality of the service (Lestari et al 2018). Aims and objectives To Explore the feasibility of afternoon teaching sessions and examine methods of increasing the MDT’sknowledge whilst portraying the development and effectiveness of IPE through the use of daily ‘ Afternoon TEA-ching sessions’ at ward level with a multi-disciplinary approach to teaching. Methods/Interventions 2–4 planned weekly teaching sessions. Organised on a monthly basis by the clinical educational facilitator ,facilitated at ward level. Results/Findings After 3 months of teaching sessions (62 sessions including unplanned sessions) questionnaires were distributed to participants (n=16).100% of those questioned felt that all teaching sessions were valuable to their practice. 100% agreed that the sessions were facilitated effectively. 94% suggested areas in which they would like teaching sessions such as arterial line, peritoneal dialysis, resus scenarios. . 100% questioned had attended a variety of sessions at ward level. Conclusions Clinical Educators and Department managers have a fundamental role in facilitating Inter professional Education (IPE). Our data shows that all staff found teaching sessions accessible, relevant, practical, inclusive. All staff indicated an interest in sustaining teaching sessions as a form of IPE on an ongoing basis at ward level. IPE is a cost effective, feasible and beneficial method of enhancing MDT knowledge on all relevant topics.
Incorporating Biopsychosocial-Spiritual Resources in Emotionally Focused Couple Therapy

Incorporation of important biopsychosocial-spiritual (BPS-S) resources in therapy is rarely outlined within the major systemic therapy models used by couple, marriage, and family therapists. A growing body of empirical literature indicates that incorporating BPS-S resources in therapy could help to accelerate and improve client outcomes. Incorporating BPS-S resources in emotionally focused couple therapy (EFT) is particularly challenging because of the primary emphasis of EFT on couple attachment. The purpose of this paper is to provide clinicians with practical guidance regarding how to incorporate BPS-S resources into EFT. We broadly consider valuable resources within each domain of the BPS-S model which, when incorporated into EFT, could help enhance treatment effectiveness. Specific clinical guidance regarding how to incorporate one resource from each domain of the BPS-S (exercise, mindfulness, volunteerism, and petitionary prayer) into EFT is also provided.
Adolescent and Young Adult Oral Maxillofacial Tumors: A Single-Institution Case Series and Literature Review

Adolescent and young adult (AYA) oral maxillofacial tumors are rare and account for ∼12% of all AYA cancers. Due to the low incidence of these malignancies, diagnostic considerations, therapeutic approaches, and factors affecting prognosis have been difficult to characterize. Given the anatomic structures located within the head and neck, patients are at risk for treatment-related morbidity that may adversely impact their quality of life. We present a single-institution case series of AYA patients with oral maxillofacial tumors treated at the University of Illinois at Chicago. A multidisciplinary treatment approach, including collaboration with the Oral Maxillofacial Surgery, Dentistry, and the Ear, Nose, and Throat teams along with the utilization of Children's Oncology Group treatment protocols, can serve as a model to address the challenges in the management of these complex cases.
Characterising the effect of different modes of particle breakage on coarse gangue rejection for an orogenic gold ore

ABSTRACTEnrichment and metal deportment metallurgical parameters, indicative of the propensity for a comminuted ore to preferentially concentrate metal into multiple density fractions during coarse...
Did religion play a role in the evolution of morality

The question of whether religion played a role in the evolution of morality can be interpreted in different ways. I consider three. On the first interpretation, “morality” is understood as an evolv...
David Oliver: Do the NHS workforce plans really add up?

Workforce recruitment, retention, and morale are the biggest threats to the viability, quality, and scope of health and care services in the UK. We need credible solutions, quickly. July saw the publication of the We are the NHS: People Plan for 20/21 for England and a “further details” Home Office document on implementing the new UK-wide, points based immigration system.12345 In 2018 a joint report by the King’s Fund, Nuffield Trust, and Health Foundation found that around one in 11 clinical posts throughout the NHS was vacant, including one in eight nursing vacancies, and vacancy rates are higher in some areas of geography or practice.6 The Health Foundation has reported a dramatic drop in nurses coming from overseas during the pandemic.7 And the Royal College of Nursing …
Weed-suppressive bacteria effects differ in culture compared to in soils and with or without microbial competition and separation of active ingredient

Abstract Weed-suppressive bacteria (WSB), specifically the D7 and ACK55 strains of Pseudomonas fluorescens, were previously reported to selectively inhibit growth of invasive annual grasses (IAGs) that have caused severe ecosystem degradation across much of the western US. However, recent studies show highly mixed evidence for WSB effectiveness in field settings. We evaluated how the effectiveness of WSB, specifically selective inhibition of exotic annual but not native perennial grasses, was altered by (1) growth media (soil vs. agar culture), (2) pre-sterilization to remove competing microbes, and (3) WSB concentration, reduced by centrifuging with and without filtration. WSB had no effects in soil microcosms with or without pre-sterilization, but WSB did have effects in agar cultures. On agar, WSB effects were amplified by pre-sterilizing seeds prior to treatment with WSB inoculum – but effects were non-selective (i.e., native and exotic plants were equally inhibited) with or without pre-sterilization at high WSB concentration. The only selective effects of WSB were observed on agar at low WSB concentrations, made possible by centrifuging WSB cells out of the inoculum prior to treatment application (from ~107 to ~105 live cells/ml). Completely removing WSB cells from inoculum by filtration led to no WSB effects. While these results suggest the desired effects of WSB can be reproduced on agar with a supernatant containing the putative active agent and a low density of WSB cells, the effect is still not reproducible for plants in soil, even when competing microbes are removed. Thus, additional research is needed to determine if, when, where, and how WSB could be effective in field settings.
Contemporary Revascularization Strategies and Outcomes Among Patients With Diabetes With Critical Limb Ischemia: Insights From the National Inpatient Sample

Abstract Objectives The purpose of this study was to evaluate temporal trends in the frequency of revascularization and associated outcomes in patients with diabetes mellitus and critical limb ischemia (CLI). Background Little is known about outcomes following revascularization for CLI in patients with diabetes mellitus. Methods Temporal trends in hospitalization for CLI among patients with diabetes were determined using the 2002–2015 National Inpatient Sample database. Propensity score matching was used to compare patients who underwent revascularization with those who did not and, separately, to compare those who underwent endovascular versus surgical revascularization. The main study outcome was in-hospital mortality. Results The analysis included 1,222,324 hospitalizations. The number of hospitalizations for CLI among patients with diabetes increased over time (ptrend Conclusions In this national analysis of patients with DM and CLI, we demonstrated an increase in hospitalization for CLI among patients with diabetes in the United States. Although in-hospital mortality decreased over time regardless of the treatment strategy used, this outcome occurred less frequently among those who underwent revascularization than not. Compared with surgical revascularization, endovascular revascularization was associated with lower in-hospital mortality but higher rates of major amputation.
What was it like to be an ESL teacher in 2020? Reflections from the prek-12 community

Suddenly, with the advent of COVID-19, our familiar teaching tools disappeared. How, in a two-dimensional world, were teachers to connect with students? This is a question we have all been asking ourselves since last spring — and when we began to discuss this forum, it was the question we posed to our community. We asked student teachers, cooperating teachers, and student-teacher supervisors to reflect on a single moment from this past year. We hoped to document — and to share — a few moments from the actual experience being an ESL teacher during the 2020 school year.
The Impact of Narrow and Tiered Networks on Costs, Access, Quality, and Patient Steering: A Systematic Review:

Health insurers use narrow and tiered networks to lower costs by contracting with, or favoring, selected providers. Little is known about the contemporary effects of narrow or tiered networks on ke...
ASSAY OF PROTEOLYTIC ACTIVITY IN THE DIAGNOSIS OF PANCREATIC FUNCTION

Difficulties in the proper use of the gelatin-viscosity test for assay of proteolytic activity have been discussed. It is the author9s opinion that for routine clinical diagnostic studies the Andersen-Early test is sufficiently accurate and much simpler. The considerations presented regarding measurement of pancreatic function and interpretation of data justify a critical attitude toward accepting some of the published data regarding normal and partial or progressive loss of pancreatic function. That such possibilities may exist is not denied, but the actual incidence must be determined by proper application and interpretation of results from sound methods for assay of pancreatic enzymes in duodenal fluid.
Host and gut microbiota symbiotic factors: lessons from inflammatory bowel disease and successful symbionts.

Summary Humans are colonized by a diverse collection of microbes, the largest numbers of which reside in the distal gut. The vast majority of humans coexist in a beneficial equilibrium with these microbes. However, disruption of this mutualistic relationship can manifest itself in human diseases such as inflammatory bowel disease. Thus the study of inflammatory bowel disease and its genetics can provide insight into host pathways that mediate host–microbiota symbiosis. Bacteria of the human intestinal ecosystem face numerous challenges imposed by human dietary intake, the mucosal immune system, competition from fellow members of the gut microbiota, transient ingested microbes and invading pathogens. Considering features of human resident gut bacteria provides the opportunity to understand how microbes have achieved their symbiont status. While model symbionts have provided perspective into host–microbial homeostasis, high-throughput approaches are becoming increasingly practical for functionally characterizing the gut microbiota as a community.
Widespread distribution of reticulon-3 in various neurodegenerative diseases

Reticulons are a group of membrane-bound proteins involved in diverse cellular functions, and are suggested to act as inhibitors of β-secretase enzyme 1 (BACE1) activity that cleaves amyloid precursor protein. Reticulons are known to accumulate in the dystrophic neurites of Alzheimer's disease (AD), and studies have suggested that alterations in reticulons, such as increased aggregation, impair BACE1 binding, increasing amyloid-β production, and facilitating reticulon deposition in dystrophic neurites. To further characterize the cellular distribution of reticulon, we examined reticulon-3 expression in cases of AD, Parkinson's disease, and diffuse Lewy body disease. A more widespread cellular distribution of reticulon-3 was noted than in previous reports, including deposits in dystrophic neurites, neuropil threads, granulovacuolar degeneration, glial cells, morphologically normal neurons in both hippocampal pyramidal cell layer and cerebral neocortex, and specifically neurofibrillary tangles and Lewy bodies. These results are compatible with reticulon alterations as nonspecific downstream stress responses, consistent with its expression during periods of endoplasmic reticulum stress. This emphasizes the increasing recognition that much of the AD pathological spectrum represents a response to the disease rather than cause, and emphasizes the importance of examining upstream processes, such as oxidative stress, that have functional effects prior to the onset of structural alterations.
Peripheral sensitization of sensory neurons.

Introduction Defining the sites and mechanisms of nociception is an important step in understanding and treating pain. During inflammation, increased nociceptive input from an inflamed organ can sensitize neurons that receive convergent input from an unaffected organ, but the site of visceral cross-sensitivity is unknown. This study examined the cellular responses to ATP and substance P stimulation in sensory neurons innervating visceral organs. Methods Lumbosacral dorsal root ganglia (L6-S1) were cut into slices and processed for substance P receptor expression using immunocytochemistry. Primary culture of dorsal root ganglion (DRG) neurons was used for [Ca2+]i measurement by videomicroscopy. Results DRG neurons express substance P receptors. Both brief addition of low dose adenosine triphosphate (ATP, 5 microM) and substance P (10 microM) significantly increased subsequent ATP stimulation at the same neuron. Discussion Sensitization of the DRG neurons innervating the different organs may be through the release of nociceptive transmitters such as ATP and/or substance P within the ganglion. Together, these experiments will increase our understanding of the important modulatory role of peripheral sensitization in nociceptive transmission and suggest potential periphepheral sites for therapeutic intervention.
Sequence-Specific Alterations of Epitope Production by HIV Protease Inhibitors

Ag processing by intracellular proteases and peptidases and epitope presentation are critical for recognition of pathogen-infected cells by CD8+ T lymphocytes. First-generation HIV protease inhibitors (PIs) alter proteasome activity, but the effect of first- or second-generation PIs on other cellular peptidases, the underlying mechanism, and impact on Ag processing and epitope presentation to CTL are still unknown. In this article, we demonstrate that several HIV PIs altered not only proteasome but also aminopeptidase activities in PBMCs. Using an in vitro degradation assay involving PBMC cytosolic extracts, we showed that PIs altered the degradation patterns of oligopeptides and peptide production in a sequence-specific manner, enhancing the cleavage of certain residues and reducing others. PIs affected the sensitivity of peptides to intracellular degradation, and altered the kinetics and amount of HIV epitopes produced intracellularly. Accordingly, the endogenous degradation of incoming virions in the presence of PIs led to variations in CTL-mediated killing of HIV-infected cells. By altering host protease activities and the degradation patterns of proteins in a sequence-specific manner, HIV PIs may diversify peptides available for MHC class I presentation to CTL, alter the patterns of CTL responses, and provide a complementary approach to current therapies for the CTL-mediated clearance of abnormal cells in infection, cancer, or other immune disease.
Hybrid adaptive control of linear systems by parallel processing and switched capacitor techniques

The implementation of a direct adaptive control algorithm using parallel processing techniques is discussed. The controller presented is hybrid in nature (continuous time feedback and discrete time gain adjustment) and recursive least squares identification is implemented using a well-known algorithm based on the Givens rotation. The main feature of the proposed scheme is the fact that it is designed for implementation on systolic arrays (for parameter identification) and switched-capacitor technology (to implement the compensator with adjustable parameters). Adaptive identification can be performed by two identical systolic arrays which triangularize appropriate matrices by use of orthogonal operations. >
Erectile Dysfunction: an Early Sign of Cardiovascular Disease

Identification of vasculogenic erectile dysfunction (ED) should be used to focus preventive efforts on reducing the risk of future cardiovascular events. For younger men 40 to 60 years old believed to have predominantly vasculogenic ED, we recommend an algorithm for further assessment of cardiovascular disease modified from the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) risk assessment guidelines. We propose that all men with confirmed vasculogenic ED and no overt cardiovascular disease symptoms undergo noninvasive evaluation using a coronary artery calcium (CAC) score. For men with low to intermediate risk (atherosclerotic cardiovascular disease (ASCVD) risk score 0–10 %), CAC score can be used to guide decisions regarding initiation of therapies, and in patients with high CVD risk, after referral to a cardiologist for a full evaluation, CAC can be used to guide intensity of therapies. We recommend that men with ED be evaluated using this modified risk assessment to incorporate factors otherwise excluded from the ACC/AHA calculator.
Mitochondrial dysfunction and oxidative stress in Parkinson's disease and monogenic parkinsonism

The pathogenic mechanisms that underlie Parkinson's disease remain unknown. Here, we review evidence from both sporadic and genetic forms of Parkinson's disease that implicate both mitochondria and oxidative stress as central players in disease pathogenesis. A systemic deficiency in complex I of the mitochondrial electron transport chain is evident in many patients with the disease. Oxidative stress caused by reactive metabolites of dopamine and alterations in the levels of iron and glutathione in the substantia nigra accompany this mitochondrial dysfunction. Recent evidence from studies on the genetic forms of parkinsonism with particular stress on DJ-1, parkin, and PINK-1 also suggest the involvement of mitochondria and oxidative stress.
Effects of sulfurization temperature on CZTS thin film solar cell performances

Abstract Synthesis of Cu 2 ZnSnS 4 thin film solar cells by sulfurization of sputtered Sn/Zn/Cu precursors is studied. The sulfurization temperatures were varied, and the morphology, cross section, and composition of the CZTS were investigated by scanning electron microscopy, energy dispersive spectroscopy, X-ray diffraction and Raman scattering. To further explore the CZTS layer, the following additional layers were deposited to complete the solar cells: CdS with chemical bath deposition; ZnO and AZO with RF magnetron deposition; and, finally, silver fingers as the front contact. The efficiency and characteristics of the thin film solar cells were measured and a detailed comparison is reported. Sulfurization at 550 °C yields a maximum efficiency of 5.75% without any anti-reflective layers.
Dynamic mechanical analysis of poly-α-amino acids. Models for collagen

Abstract A series of copolymers of L-leucine and L-glutamic acid was prepared as a model system for collagen, and the dynamic mechanical behavior was investigated as a function of water content. The results suggest a spectrum of waterpolymer interactions with the two predominant types represented by “tightly bound” and “loosely bound” water. Each gives rise to a characteristic relaxation peak: the former at 180–200°K (1 Hz) and the latter at about 260°K (1 Hz). One of the poly-α-amino acids, a 50:50 copolymer of L-leucine and L-glutamic acid, sorbed an amount of water comparable to that of native collagen. Below physiological temperature the relaxation spectrum of this polymer closely resembles that reported for collagen in both temperature location and intensity of relaxation peaks. This suggests that the use of model polymers may be of significant value in elucidating the structure and function of water in structural proteins.