cssi/SciSciGPT-SciSciNet huggingface dataset:
Effects of Three Pedagogies on Learning Outcomes in a Psychology of Gender Lecture: A Quasi-Experimental Study

This study employed a quasi-experimental design to test the effects of three pedagogies on learning outcomes in a simulated psychology of gender lecture. Results showed that meaning and relational pedagogies, as well as a combination of meaning, relational, and explanatory pedagogies, significantly improved participant learning beyond self-study and produced a significant improvement in retention as well. Interestingly, participants in the relational condition excelled on these learning outcomes even though the instructor covered very little reading material in that condition. Despite the benefits of these pedagogies, participants showed a clear preference for the lower performing explanatory instructional approach, which suggests that students may not readily recognize pedagogies that best contribute to effective learning and retention in classes like the psychology of gender.
“Antic Clay”?: The Competing Ethical Appeals of Blood Meridian

Chapter Three complements the second chapter’s study of evil in Blood Meridian. Hillier examines whether the novel’s universe offers a counterbalancing philosophy to the Judge’s claim that the only human bonds are bonds of violence and that “[i]f war is not holy man is nothing but antic clay.” The argument first situates the novel within the genre of the Post- or anti-Western. Hillier then surveys the inadequate forms of resistance to the Judge presented by the Kentucky veteran Grannyrat, the ex-priest Tobin, and Toadvine, before turning to the kid as the novel’s most persuasive manifestation of the possibility of a moral ground. The chapter charts the kid’s moral development and explores how his growing attempts to connect and compassionate with others relate to Kantian ethics and moral law, Rousseau’s conception of the state of nature, and Behmenist voluntarism. Rousseau’s positing of a tension between natural pity and “civilized” reason seems to reflect, respectively, the kid’s innate capacity for pity, identification, and limited altruism and the Judge’s pride and mania for scientific rationalism and Enlightenment values. The threat that the kid’s moral autonomy poses to the Judge is a measure of its significance, but also confirms how different the novel would be in the kid’s absence. The novel recurrently dwells upon the idea of the witness. Its final witness, though, is neither the Judge nor the kid, but McCarthy’s reader, upon whom the burden of interpretation and moral response rests.
Glass transition prediction strategies based on the Couchman-Karasz equation in model confectionary systems

Abstract Our objectives were to compare the Couchman-Karasz-predicted glass transition temperature, TCK, to the measured glass transition temperature of a mixture, Tgm, of model confectionary systems and develop an empirical correction to improve the accuracy of prediction. Results showed that the original Couchman-Karasz equation fit the data better than the modified equation; although both generally overestimated Tgm. Blends containing sorbitol had the largest Δ T g m C K , where Δ T g m C K = T C K − T g m . While Tgm varied with composition, the increase in Tgm with decreasing moisture content was linear ( R 2 ¯ = 0.984 ) and consistent across blends (4.5 ± 0.9°C/1% moisture, wb). The increase in Tgm with increasing cook temperature was best described by a polynomial model ( R 2 ¯ = 0.998 ), but adequately described by a more generalizable linear model ( R 2 ¯ = 0.979 ). Application of an empirical correction based on moisture content or cook temperature and TCK of dry ingredients reduced the average Δ T g m C K from 20.1 °C and 11.3 °C for modified and original equations, respectively, to
A new model for a multi-disciplinary engineering summer research program for high school seniors: program overview, effectiveness, and outcomes

The High School Summer Research Program (HSSRP) is a rigorous eight-week research experience that challenges high school students to a novel scientific question in an engineering laboratory at the Henry Samueli School of Engineering and Applied Science (HSSEAS) at the University of California, Los Angeles (UCLA). The program collates highly motivated students from all socioeconomics statuses, ethnicity, and gender to increase the diversity of applicants for STEM majors at four-year universities, and thereby potentially promotes a more diverse and innovative STEM workforce. To supplement students' unique research projects, HSSRP comprises several professional development opportunities, such as faculty presentations, lab tours, and industry tech talks. Students are trained to communicate their research through scientific posters and oral presentations in a ''learn-by-teaching'' system that further exposes all students to the multitude of creative strategies that are currently employed across the engineering disciplines to tackle world issues. This integrates with HSSRP's strong social element, which encourages students to act as a support system for each other in the midst of the challenging eight weeks, and serves as a network for students after the program. A survey of the 2014-2016 HSSRP classes indicates high satisfaction with the program, and a high liklihood of pursuing a STEM degree and advanced STEM degrees. Surveys of HSSRP alumni shows that a vast percentage of students are pursuing STEM degrees or are currently working in the STEM field.
Recent trends in liver transplantation for alcoholic liver disease in the United States.

Aim To examine temporal changes in the indications for liver transplantation (LT) and characteristics of patients transplanted for alcoholic liver disease (ALD). Methods We performed a retrospective cohort analysis of trends in the indication for LT using the United Network for Organ Sharing (UNOS) database between 2002 and 2015. Patients were grouped by etiology of the liver disease and characteristics were compared using χ2 and t-tests. Time series analysis was used identifying any year with a significant change in the number of transplants per year for ALD, and before and after eras were modeled using a general linear model. Subgroup analysis of recipients with ALD was performed by age group, gender, UNOS region and etiology (alcoholic cirrhosis, alcoholic hepatitis and hepatitis C - alcoholic cirrhosis dual listing). Results Of 74216 liver transplant recipients, ALD (n = 9400, 12.7%) was the third leading indication for transplant after hepatitis C and hepatocellular carcinoma. Transplants for ALD, increased from 12.8% (553) in 2002 to 16.5% (1020) in 2015. Time series analysis indicated a significant increase in the number of transplants per year for ALD in 2013 (P = 0.03). There were a stable number of transplants per year between 2002 and 2012 (linear coefficient 3, 95%CI: -4.6, 11.2) an increase of 177 per year between 2013 and 2015 (95%CI: 119, 234). This increase was significant for all age groups except those 71-83 years old, was observed for both genders, and was incompletely explained by a decrease in transplants for hepatitis C and ALD dual listing. All UNOS regions except region 9 saw an increase in the mean number of transplants per year when comparing eras, and this increase was significant in regions 2, 3, 4, 5, 6, 8, 10 and 11. Conclusion There has been a dramatic increase in the number of transplants for ALD starting in 2013.
CPHD Filter Birth Modeling Using the Probabilistic Admissible Region

Sparse observations make single-point track initialization difficult in some multitarget tracking scenarios, including space-object tracking. A probabilistic admissible region approach combines physics- and scenario-based constraints in unobservable directions to reduce ambiguity in the initial state and allows for a birth model consistent with the derivation assumptions in the cardinalized probability hypothesis density filter. The proposed filter enables tracking of simulated space objects via optical or radar observations and establishes custody of newly observed targets when given sparse observations.
Pharmacokinetic studies on quinacrine following intrauterine administration to cynomolgus monkeys

Recent efforts have been made to develop a chemical oviductal occluding agent. Intrauterine quinacrine has been used in certain areas of the world with moderate success in effected tubal closure. This report presents the pharmacokinetics of a quinacrine solution (30 mg) as administered to cynomolgus monkeys via the intrauterine route, compared with intravascular injection. The data show rapid transfer of the drug from the uterine to the vascular compartment and uptake by almost all tissues examined. Although plasma concentrations disappear within 24 hours, levels can be detected in most tissues for at least 1 week following intrauterine injection. After 28 days, however, tissue levels of the drug are absent or near the limit of detection.
Automated Percutaneous Discectomy: Preliminary Experience

In 1985, Onik, described a new automated lumbar disc aspiration technique that utilizes a probe with the guillotine cutting technology used in vitrectomy and arthroscopic instrumentation. The probe’s small size (2 mm in diameter) minimizes the risk of nerve injury, while its automated action permits rapid, safe removal of disc material. The technique and our preliminary results in patients treated with this method are described.
Sleep and Shift Work

Shift work is a necessary component of modern society. Unfortunately, there are numerous well-documented negative effects of shift work including decreased sleep, poor sleep, increased sleepiness, decreased alertness, decreased performance efficiency, and increased incident rates of numerous medical concerns. Night shift work results in the most negative effects on the worker, followed by day shift work, especially if the day shift work starts relatively early in the morning. Afternoon shift work has few negative effects on sleep and health but can create social concerns because of the timing of the work shift. Although there are a number of ways that organizations and workers can attempt to adapt to different shift work paradigms, it is important to remember that shift work, especially night shift work, results in problems maintaining wakefulness and subsequent decreases in performance. Integrating better countermeasures in the work place and educating the workers better about potential coping strategies is essential to help manage the situation.
Runtime Scheduling Policies for Distributed Graph Algorithms

In this paper we explore scheduling and runtime system support for unordered distributed graph computations that rely on optimistic (speculative) execution. Performance of such algorithms is impacted by two competing trends: the higher degree of parallelism enabled by optimistic execution in turn requires substantial runtime support. To address the potentially high overhead and scheduling complexity introduced by the runtime, we investigate customizable scheduling policies that augment the scheduler of the underlying runtime to adapt it to a specific graph application. We present several implementations of Distributed Control (DC), a data-driven unordered approach with work prioritization and demonstrate that customizable scheduling policies result in the most efficient implementation, outperforming the well-known ?-stepping Single-Source Shortest Paths (SSSP) and Jones-Plassmann vertex-coloring algorithms. We apply two scheduling techniques, flow control and adaptive frequency of network progress, which allow application-level control over the balance of domain work and the runtime work. Experimental results show the benefit of such application-aware scheduling for irregular distributed graph algorithms.
Managing Chronic Conditions with a Smartphone-based Conversational Virtual Agent

When deployed on mobile devices, virtual agents have the potential to deliver advice regarding medical conditions, as well as provide a ubiquitous channel for health education and behavior change for a variety of chronic health conditions. We describe design guidelines for mobile agent dialogues to support chronic disease management, a general-purpose smartphone-based architecture for a conversational virtual agent that simulates face-to-face health counseling conversations with patients, and an initial agent implementation that provides counseling to patients with the chronic heart condition atrial fibrillation in conjunction with a mobile heart rhythm monitor that is attached to the back of the phone. Preliminary results from a randomized trial with 120 patients with atrial fibrillation indicate that the agent results in significant improvements in self-reported quality of life relative to a standard of care control group.
The Amblema plicata Transcriptome as a Resource to Assess Environmental Impacts on Freshwater Mussels

High-throughput sequencing technologies, such as RNA sequencing (RNA-Seq), have greatly enhanced our ability to sequence and characterize the transcriptome of nonmodel organisms. The ability to study expression of thousands of genes in highly threatened yet understudied organisms holds great potential for advancing the field of conservation biology. Despite rapid gains in our analytical abilities and understanding of the physiological underpinnings of the organism, genomic resources remain limited for nonmodel organisms such as freshwater mussels, one of the most imperiled groups of animals worldwide. Here we provide the first characterization of the transcriptome of the North American freshwater mussel Amblema plicata (threeridge) using an RNA-Seq approach. Gill tissue samples were collected from mussels in the Muskingum River in Washington County, Ohio, USA. RNA was extracted and sequenced on the Illumina HiSeq 2500 sequencer with output as 100-base-pair paired-end reads. De novo assembly of sequenced reads was performed using Trinity. Assembled transcripts were used as BLASTx queries against the National Center for Biotechnology nonredundant database, and functional annotation using gene ontology (GO) terms was performed using Blast2GO. Transcriptome assembly produced 264,027 transcripts. Of these transcripts, 54,331 (20.58%) received BLAST hits and 22,223 were annotated with GO terms. We provide examples of identified candidate genes that may be useful for studying physiological responses of freshwater mussels to various environmental stressors, such as temperature, hypoxia, and pollutants. The A. plicata transcriptome improves the genomic resources available for freshwater mussels, and may aid in the development of molecular tools, with the ultimate goal of increasing our understanding of freshwater mussel physiology and improving conservation techniques.
Sustainable communication: green PR and the export of corporate environmentalism, 1989–1997

This article evaluates the role of public relations (PR) consultants as influential actors in the politics of environmental governance. It examines the historical case of EnviroComm, a network of e...
A Review of: “Rhetoric in Modern Japan: Western Influences on the Development of Narrative and Oratorical Style” by Massimiliano Tomasi

Asian rhetoric has drawn much attention in American academia over the last three decades. Still, studies of Asian rhetorical traditions were often initiated from a “deficiency” model, in which the ...
Pancreas Retransplant After Pancreas Graft Failure in Simultaneous Pancreas-kidney Transplants Is Associated With Better Kidney Graft Survival.

Background Simultaneous pancreas-kidney (SPK) transplant is usually the best option for the diabetic end-stage renal disease patient. There is limited information about kidney graft outcomes in SPK recipients with isolated pancreas graft failure who do versus do not undergo pancreas retransplantation. Methods Patients were divided into 2 groups based on whether they underwent pancreas retransplant (ReTx+) or not (ReTx-). Kidney graft function and survival were the primary endpoints. Results One hundred and nine patients satisfied our selection criteria, 25 in ReTx+ and 84 in ReTx-. Mean interval from SPK to pancreas failure was significantly shorter in the ReTx+ compared with the ReTx- group, 19.3 ± 36.7 versus 45.7 ± 47.0 months (P = 0.01), respectively. There was no significant difference in kidney graft follow-up post SPK between 2 groups (P = 0.48). At last follow-up, 15 of the 25 (60%) of the repeat pancreas graft had failed, with a mean graft survival among these failed pancreas graft of 2.6 ± 2.7 years, ranging from 0 to 8.1 years. Uncensored kidney graft failure was significantly lower in the ReTx+ group compared with the ReTx- group, 44% versus 67% (P = 0.04). Death-censored kidney graft failure was also lower in the ReTx+ group, 24% versus 48% (P = 0.04). The difference in patient survival did not reach statistical significance. In adjusted Cox regression analysis, rejection as a cause of pancreas failure was associated with increased risk of death-censored kidney graft failure, and pancreas retransplantation was associated with decreased risk of kidney graft failure. A similar pattern was seen after 1:1 matching for the interval between SPK and pancreas graft failure. Conclusions Even though ReTx+ patients accept the risks associated with repeat pancreas surgery, providers should consider this option in suitable otherwise healthy patients.
Long-Term Oncologic Outcomes After Robotic Lobectomy for Early-stage Non-Small-cell Lung Cancer Versus Video-assisted Thoracoscopic and Open Thoracotomy Approach.

Abstract Background Although robotic-assisted lobectomy has been increasingly used for resection of non–small-cell lung cancer (NSCLC), the long-term oncologic outcomes compared with video-assisted thoracoscopic surgery (VATS) and the open thoracotomy approach have remained ill-defined. Patients and Methods Society of Thoracic Surgeons outcomes data and surveillance records of patients with stage I-IIIa NSCLC who had undergone lobectomy by robotic-assisted, VATS, or the open approach at a single center from 2012 to 2017 were reviewed. Propensity score adjustment by inverse probability of treatment weighting was used to balance the baseline characteristics. Recurrence and survival were analyzed and compared by the operative approach. Results The inverse probability of treatment weighting-adjusted cohort included 514 patients with NSCLC who had undergone robotic-assisted (n = 245), VATS (n = 118), and open (n = 151) lobectomy, with similar patient and disease characteristics. The minimally invasive procedures were associated with a shorter median hospital length of stay (robotic, 5.2 days; VATS, 4.9 days; open, 7.3 days; P Conclusion Robotic lobectomy was associated with durable freedom of recurrence and long-term survival equivalent to those achieved with VATS and the traditional open thoracotomy approach.
Reflective practice and health sciences librarians: engagement, benefits, and barriers.

Objective: Reflective practice is common in nursing and other professions. In the published literature, there is very little about librarians’ use of reflective practice and no studies of health librarians’ use of reflective practice. This study examined the use of reflective practice among health sciences librarians, perceived benefits, and perceived barriers to use. Methods: This cross-sectional study replicated the 2014 study by Greenall and Sen, using a version of their questionnaire. The research population in this study was health sciences librarians who were members of the MEDLIB-L email discussion list, Medical Library Association (MLA) chapter email discussion lists, and/or MLA section email discussion lists. Results: There were 106 librarians who completed the questionnaire, ranging from those new to the profession through midcareer to longtime librarians. While a high percentage of respondents considered themselves to be reflective practitioners (77%), a larger percentage (87%) reported that they consciously spent time reflecting. Respondents selected a wide variety of benefits of reflective practice, while barriers tended to center on lack of time, knowledge, skills, or experience. Conclusion: The diversity of benefits that respondents selected suggests that reflective practice can play an important positive role in librarians’ professional development. Reported barriers to reflective practice suggest that there is a need for educational opportunities to develop skills. This article has been approved for the Medical Library Association’s Independent Reading Program .
Histopathological characteristics of surgical tissue from primary vs recurrent chronic rhinosinusitis with nasal polyposis patients

Objective The histopathological characteristics of primary vs recurrent nasal polyps in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) have not been studied comprehensively. Identification of these features may be helpful for prognostication, postoperative management, and consideration of novel eosinophil-targeting biologic therapy. This study investigates the histopathological differences in primary vs recurrent CRSwNP tissue. Methods Patients undergoing endoscopic sinus surgery for CRSwNP were included if all 13 histopathological and mucin characteristics on a standardized report were available. Histopathology parameters were compared in surgical tissue and mucin from primary vs recurrent CRSwNP. Results Complete structured histopathology reports were available for 96 patients (39 primary polyps and 57 recurrent polyps). Compared to primary polyp tissue, recurrent CRSwNP mucin was significantly more likely to feature eosinophil aggregates (57.9% vs 35.9%; P = .047). Tissue eosinophilia (using a threshold >10 per high power field [HPF]) was not significantly different in primary and recurrent CRSwNP tissue. Other histopathologic parameters and clinical characteristics were similar. Conclusion Eosinophil aggregates on histopathology are significantly more likely to be present in recurrent CRSwNP. In the limited series, tissue eosinophilia (>10 per HPF) was not significantly different in primary and recurrent CRSwNP. Therefore, in addition to the study of tissue eosinophilia levels, Rhinologic surgeons should also direct attention to CRSwNP mucin. Mucin eosinophilic aggregates are an independent marker of severe inflammation that is associated more likely with recurrent vs primary polyposis. Further study of this marker may help determine its role of choice of postoperative medical therapies, including anti-eosinophilic biologics. Level of Evidence 4.
Structural evidence for a dynamic metallocofactor during N 2 reduction by Mo-nitrogenase

The enzyme nitrogenase uses a suite of complex metallocofactors to reduce dinitrogen (N2) to ammonia. Mechanistic details of this reaction remain sparse. We report a 1.83-angstrom crystal structure of the nitrogenase molybdenum-iron (MoFe) protein captured under physiological N2 turnover conditions. This structure reveals asymmetric displacements of the cofactor belt sulfurs (S2B or S3A and S5A) with distinct dinitrogen species in the two αβ dimers of the protein. The sulfur-displaced sites are distinct in the ability of protein ligands to donate protons to the bound dinitrogen species, as well as the elongation of either the Mo-O5 (carboxyl) or Mo-O7 (hydroxyl) distance that switches the Mo-homocitrate ligation from bidentate to monodentate. These results highlight the dynamic nature of the cofactor during catalysis and provide evidence for participation of all belt-sulfur sites in this process.
Management of bone health in men with prostate cancer

Abstract Prostate cancer (PCa) is the second most common cancer in men worldwide and primarily affects older men. Androgen deprivation therapy (ADT) is the mainstay of systemic therapy for this disease. Although ADT is an effective treatment to lower testosterone levels and inhibit PCa cell proliferation, it causes significant adverse effects. This includes, although not limited to, a major impact on bone health to accelerate bone loss and increase the incidence of fractures, which can have a significant negative impact on the quality of life as well as survival. The negative impacts on bone can be mitigated with appropriate nonpharmacologic and pharmacologic therapies. There are now many trials demonstrating the efficacy of bisphosphonate and denosumab treatment to prevent bone loss in this population, although fracture data are more limited. While clinical guidelines exist for the screening and optimal management of men with PCa, many men do not receive bone mineral density examinations to assess fracture risk at the onset of ADT. Further, counseling on nonpharmacologic and pharmacologic therapies to maximize bone health is too often overlooked in the overall care of this patient population. As survival of men with PCa improves with newer therapies, future efforts are crucial to address the treatment gap in care of this growing population.
Mediastinal IgG4-Related Disease Manifesting as Superior Vena Cava Syndrome.

Immunoglobulin G4 (IgG4)–related disease was first identified as a systemic condition in 2003 when extrapancreatic manifestations were identified in patients with autoimmune pancreatitis. Its peak incidence occurs in the fifth or sixth decades of life. Isolated extraaortic mediastinal involvement is extremely rare. This report describes a case of isolated extraaortic mediastinal IgG4-related disease encasing the superior vena cava (SVC) and manifesting as SVC syndrome in a 25-year-old man with no personal or family history of autoimmune disease. Resection with SVC reconstruction was performed.
MuSK Antibody Positive Myasthenia Gravis Presenting with Bilateral Vocal Cord Abduction Paralysis: A Case Report and Literature Review (1418)

Objective: To present the case of a patient with muscle-specific tyrosine kinase (MuSK) antibody positive myasthenia gravis presenting with hoarse voice secondary to bilateral vocal cord abduction paralysis and review the literature on MuSK myasthenia gravis. Background: Approximately 39–49% of patients with previously diagnosed acetylcholine receptor antibody-negative myasthenia gravis have been found to be MuSK antibody positive. These patients have a presentation that typically includes oculobulbar weakness, poorer response to cholinesterase inhibitors and are higher risk for acute clinical decompensation that necessitates plasma exchange (PLEX). MuSK patients can require more aggressive maintenance immunosuppression earlier on to maintain stability, often with rituximab. Design/Methods: We report the case of a 45 year old female who presented with months of worsening hoarseness and exertional dyspnea that was discovered to be secondary to limited abduction of vocal cords bilaterally. Exam revealed ophthalmoparesis and fatigueable proximal muscle weakness. She was found to have elevated MuSK autoantibodies which, along with evidence of neuromuscular junction transmission defect on nerve conduction studies, confirmed the diagnosis of MuSK myasthenia gravis. She experienced no improvement with pyridostigmine and decompensated despite receiving oral steroids, requiring intubation. Fortunately, she improved with PLEX and has since been doing well on rituximab therapy. Results: NA Conclusions: Dysphonic voice with hoarse quality secondary to vocal cord abduction paralysis is a rare presentation of myasthenia gravis, as opposed to the typical flaccid dysarthria seen in bulbar myasthenia, and should raise suspicion for MuSK antibody positivity. MuSK myasthenia gravis cases can be more refractory to treatment with cholinesterase inhibitors and are more likely to cause exacerbations and myasthenia crisis. Therefore, early and accurate diagnosis with appropriate antibody testing is imperative to avoid delays in treatment to prevent potentially life-threatening outcomes. Disclosure: Dr. Santilli has nothing to disclose. Dr. Stitt has nothing to disclose.
Rural hospitals are not associated with worse postoperative outcomes for colon cancer surgery.

Purpose We sought to determine whether colorectal cancer surgery can be done safely at rural hospitals. The current study compared outcomes among rural patients who underwent colon resection at rural and nonrural hospitals. Methods Medicare beneficiaries who underwent colon resection for cancer between 2013 and 2017 were identified using the Medicare Inpatient Standard Analytic Files. Patients and hospitals were designated as rural based on rural-urban continuum codes. Risk-adjusted postoperative outcomes and hospitalization spending were compared among patients undergoing resection at rural versus nonrural hospitals. Results Among 3,937 patients who resided in a rural county and underwent colon resection for cancer, mean age was 76.3 (SD: 7.1) years and 1,432 (36.4%) patients underwent operative procedure at a rural hospital. On multivariable analyses, no differences in postoperative outcomes were noted among Medicare beneficiaries undergoing colon resection for cancer at nonrural versus rural hospitals. Specifically, the risk-adjusted probability of experiencing a postoperative complication at a nonrural hospital was 15.4% (95% CI: 14.1%-16.8%) versus 16.3% (95% CI: 14.2%-18.3%) at a rural hospital (OR 1.08, 95% CI: 0.85-1.38); 30-day mortality (nonrural: 2.9%, 95% CI: 2.2-3.6 vs rural: 3.5%, 95% CI: 2.4-4.5) was also comparable. In addition, price standardized, risk-adjusted expenditures were similar at nonrural ($18,610, 95% CI: $18,037-$19,183) and rural ($19,010, 95% CI: $18,630-$19,390) hospitals. Conclusion Among rural Medicare beneficiaries who underwent a colon resection for cancer, there were no differences in postoperative outcomes among nonrural versus rural hospitals. These findings serve to highlight the importance of policies and practice guidelines that secure safe, local surgical care, allowing rural clinicians to accommodate strong patient preferences while delivering high-quality surgical care.
The role of patient primary language in access to brain tumor resection: Evaluating emergent admission and hospital volume

Abstract Background This study investigated the effect of limited English proficiency on access to neuro-oncologic surgery. We compared rates of emergent/urgent admission and admission to high-volume hospitals for English and non-English primary language patients with brain neoplasms. Methods Using the AHRQ-HCUP New Jersey State Inpatient Database, we included patients 18–90 years old who underwent resection of a supratentorial primary brain tumor (PBT), meningioma (MA) or brain metastasis (BM) from 2009–2017. Outcomes were emergent/urgent admission and annual hospital procedure volume. Univariable and multivariable analyses compared Spanish (SPL), Non-English Non-Spanish (NENS), and English (EPL) primary language groups. Results 7,402 patients were included: 2,996 PBT, 2,115 MA, and 2,291 BM. SPL patients (n = 300) were younger and had a greater proportion of non-commercially insured, low-income patients with lower comorbidity scores. NENS patients (n = 260) had similar age and comorbidity scores as EPL patients, but a greater proportion had non-commercial insurance and low income (p Conclusion Patient primary language may influence access to timely neurosurgical care, but access to high-volume centers appears to be mediated by other factors. Policy summary statement In addition to efforts to improve health care access for patients with limited English proficiency, multilingual health literacy and patient education interventions may help to promote timely presentation for brain tumor resection among this vulnerable patient population.
MELD-Na > 16 is associated with high peri-procedural and short-term mortality in patients with ruptured hepatocellular carcinoma treated with emergent transarterial embolization

To evaluate prognostic factors associated with peri-procedural (30 days) and short-term (90 days) mortality in the United States cohort of patients following emergent transarterial embolization for ruptured hepatocellular carcinoma. Patients with ruptured hepatocellular carcinoma treated with emergent TAE between January 2001 and December 2019 were retrospectively identified (n = 24). Average age was 62 years (range, 23–78 year); 15 (62.5%) were men. Univariate and Cox proportional hazard modeling were used to determine independent predictors of overall survival (OS) following TAE. OS stratified by Model for End-Stage Liver Disease-Sodium score was assessed using Kaplan–Meier analysis. Twenty-one patients (88%) died during a mean clinical follow-up period of 328 ± 139 days. MELD-Na score (HR 1.22 per 1-unit increase; 95% CI 1.06–1.46; p = 0.005) and pre-rupture ECOG PS score (HR 8.1; 95% CI 1.28–51.2; p = 0.026) were independent predictors of decreased overall survival. There was no significant association between overall survival and presence of cardiovascular co-morbidities (p = 0.60), hemorrhagic shock on presentation (p = 0.16), portal vein thrombus (p = 0.08), vasopressor support required (p = 0.79), intubation required (p = 0.40), acute kidney injury (p = 0.58), and number of packed red blood cell transfusions (p = 0.22). The median OS was 64 days. Median OS was significantly greater in patients with a MELD-Na score ≤ 16 as compared to those with a MELD-Na score > 16 (166.5 days vs 9 days, p = 0.011). Cumulative OS rates in those with a MELD-Na score ≤ 16 at 30, 60, 90, and 360 days were 79%, 64%, 64%, and 25%, respectively, vs 33%, 33%, 11%, and 0%, respectively, in those with a MELD-Na score > 16. MELD-Na > 16 is associated with very high peri-procedural (67% at 30 days) and short-term (89% at 90 days) mortality in patients with ruptured HCC treated with emergent transarterial embolization. A better understanding of these prognostic factors may help guide treatment decisions and provide realistic expectations when counseling patients and their families.
Upper extremity deep venous thrombosis secondary to thyrotoxic periodic paralysis with accompanying hyperphosphatemia and severe hypomagnesemia

Thyrotoxic periodic paralysis is a rare but life-threatening complication of hyperthyroidism. Characteristic features involve thyrotoxicosis, acute paralysis, and hypokalemia. Mild hypomagnesemia and hypophosphatemia are also present in most cases due to the resulting transcellular shift of electrolytes. Complications of thyrotoxic periodic paralysis reported in the literature have included cerebral venous thrombosis as well as lower extremity deep venous thrombosis. We present a patient with an unusual presentation of thyrotoxic periodic paralysis as reflected by hyperphosphatemia, upper extremity deep venous thrombosis and severe hypomagnesemia. This is the first reported case of upper extremity deep vein thrombosis in association with a peripherally inserted central catheter line secondary to thyrotoxicosis.
Investigation on the endothermic event of cephalexin monohydrate in differential scanning calorimetric curve

Cephalexin BP, USP an orally active, semisynthetic cephalosporin antibiotic is made into different dosage forms. However, its melting point and decomposition temperature, two important formulation parameters, have not been clearly defined. Melt temperature at 196–198, 321–326.8 °C or unknown has been as reported in the literature. Furthermore, the study differential scanning calorimetry published by El-Shattawy et al. exhibited an exotherm with a maximum peak of transition at 195 °C. Five approaches, one- and two-step DSC, MEL-TEMP apparatus, visual inspection of powder before and after heat stress to simulate an industrial operation procedure, UV and HPLC assays, were used in this study. A sample was heated to one of the several predetermined temperatures; the calorimeter chamber was next quench-cooled to room temperature, while the sample remained inside doubly covered. It was then reheated to 250 °C to explore the endotherm at approximately 80 °C and the exotherm at 190 °C that we found in the one-step DSC study. From the integrated results of these five studies, we concluded that the melting of cephalexin is atypical and cephalexin monohydrate absorbs energy from 31.5 to 121.9 °C (with dip temperature at 69.5 ± 7.6 °C, n = 6) to allow both bound and free water to evaporate. If insisted on removing the bound water from the cephalexin monohydrate powder, the added enthalpy may endanger drug stability as the degradation starts much earlier than its actively decomposed temperature ranging from 176.2 to 200.3 °C (with apex temperature at 196.9 ± 0.3 °C, n = 6). The data also disclosed that the hydrate of cephalexin exhibits interaction with crystal structure.
SU-F-BRD-13: A Phenomenological Relative Biological Effectiveness (RBE) Model for Proton Therapy Based On All Published in Vitro Cell Survival Data

Purpose: Proton therapy treatments are currently planned and delivered using the assumption that the proton relative biological effectiveness (RBE) relative to photons is 1.1. This assumption ignores strong experimental evidence that suggests the RBE varies. A recent review study (Paganetti 2014), collected over 72 experimental reports on proton RBE, providing a comprehensive dataset for predicting proton RBE. Using this dataset we develop a model to predict RBE based on dose, linear energy transfer (LET) and the tissue specific parameter (α/β)x. Methods: The relationship of the RBE on dose, dose average LET (LETd) and (α/β)x was explored using 290 experimental data points. The RBE was calculated for each experimental point for doses ranging from 1 to 10 Gy. An RBE model, based on the linear-quadratic model, was derived using a nonlinear regression fit to the experimental data. Results: The proposed RBE model predicts that the RBE increases with LET and decreases with (α/β)x. The model additionally predicts a decrease in RBE with increasing dose for low (α/β)x values ( 4 Gy). Previous phenomenological models were based on a small subset of experimental data and deviate significantly from our findings. Conclusion: The proposed RBE model is derived using the most comprehensive collection of proton RBE experimental data to date. The model agrees with previous theoretical predictions on the relationship between RBE, LETd and (α/β)x and also makes predictions on the relationship between RBE and dose. The proposed model shows a relationship between α and LETd but no significant relationship between β and LETd. Previously published phenomenological models based on a limited data set might have to be revised.
Virtual Environments as Human-Computer Interfaces

Publisher Summary The virtual environments created through computer graphics are new communications media. They are generally experienced through head-coupled, virtual image, stereoscopic displays that can synthesize a coordinated multisensory presentation of a synthetic environment. A well-designed human computer interface gives the user an efficient, effortless flow of information between the device and its operator. When users are given sufficient control over the pattern of this interaction, they themselves can evolve efficient interaction strategies that optimize their communications to the machine. Virtualization may be defined as the process by which a viewer interprets patterned sensory impressions to represent objects in an environment other than that from which the impressions physically originate. A classical example would be that of a virtual image as defined in geometrical optics. A viewer of such an image sees the rays emanating from it as if they originated from a virtual point rather than from their actual location. Three levels of virtualization may be distinguished: virtual space, virtual image, and virtual environments. These levels represent points on a design continuum of virtualization as synthesized sensory stimuli more closely acquire the sensory and motor characteristics of a real environment.
Differentiation of malignant to benign cells.

Summary Rats bearing well-differentiated transplantable squamous cell carcinomas were given injections of thymidine-3H, and the tumors were examined at intervals of time by radioautography with light and electron microscopes. Two hr after injection, labeled cells were almost exclusively in the undifferentiated areas of the tumor, and 96 hr after injection many cells of the well-differentiated pearls were labeled. These data suggest that the growth of the tumor was dependent upon proliferation of undifferentiated cells and that the growth of the pearls was dependent upon incorporation of undifferentiated cells into the pearl. Labeled cells that migrated into the pearls became well differentiated, as determined by electron microscopic radioautography, and when transplanted into compatible hosts did not form tumors. Thus it would appear that the progeny of malignant stem cells can differentiate into postmitotic benign cells incapable of forming a tumor.
Spatial motion constraints for robot assisted suturing using virtual fixtures

We address the problem of the stitching task in endoscopic surgery using a circular needle under robotic assistance. Our main focus is to present an algorithm for suturing using guidance virtual fixtures (VF) that assist the surgeon to move towards a desired goal. A weighted multi-objective, constraint optimization framework is used to compute the joint motions required for the tasks. We show that with the help of VF, suturing can be performed at awkward angles without multiple trials, thus avoiding damage to tissue. In this preliminary study we show the feasibility of our approach and demonstrate the promise of cooperative assistance in complex tasks such as suturing.
Preparing for the Politics of Life: An Expansion of the Political Dimensions of College Women's Literary Societies

One week before the 1908 U.S. presidential election, the women of the Hesperian Literary Society at the State University of Iowa (SUI, now the University of Iowa) presented “a unique program” in the form of a mock political rally. Imagining that they lived in a town where women had “been honored by the legislature with the ballot,” the “Hep” members divided into clubs that supported various candidates and causes. Several women formed the Utopian Club, which promoted William Jennings Bryan's presidential candidacy, while the members who comprised the Women's Culture Club supported William Howard Taft. Heps who pretended to belong to the Woman's Christian Temperance Union (WCTU) argued for prohibition. Portraying the era's political dynamism, other Heps represented anarchists, socialists, and independents. A woman from each group spoke in support of her cause in front of a crowd that included “a lot of” college men. SUI senior and Hep member Ione Mulnix described the rally in a letter to her parents: “[T]he speeches were of course very ridiculous. The reasons why each was the best were very feminine and would hardly convince a man.” She explained that the Utopian Club representative “argued for Bryan because he was the best looking.” The Heps ended their program by setting loose a toy mouse, causing the actors to scream and scatter. Finding the fictitious rally “awfully funny,” Mulnix noted that the Hep women “acted their parts to perfection” and that the college men “seemed to appreciate it immensely.”
Comprehensive mapping of knowledge and information resources: the case of webster

To maximize the representational and pedagogical effectiveness of computer-based concept maps, such maps should be able to incorporate any sort of media that can be represented in the computational environment. This chapter proposes cognitive and educational rationale for this thesis, and discusses an instantiation of these ideas in the form of a Web-based concept mapping tool named Webster. Webster permits broad flexibility in terms of the kinds of knowledge and information that may be represented and the structuring of their visual presentation. One result of this approach is the integration of knowledge visualization and information visualization in a single representational medium. These facilities also make Webster a convenient tool for personal knowledge management, facilitating individual organization of knowledge and external knowledge and information resources for reference and learning purposes.
Knowing for Nursing Practice: Patterns of Knowledge and Their Emulation in Expert Systems

The relationship between knowledge and expert systems, and the related issue of how to emulate the former in the latter, is perhaps the most central issue in artificial intelligence research efforts in many fields, including nursing. Most often the issue is phrased as one of how to emulate knowledge, which is a question pertaining to the technical feasibility of knowledge representation. Thus, there is debate about the relative merits of different modes of knowledge representation in artificial intelligence (e.g., production rules, frames, semantic networks, etc.), and, relatedly, about different methods of knowledge acquisition (e.g., conventional knowledge engineering, induction from example, etc.). It speaks to the progress being made in the field of artificial intelligence that problems surrounding knowledge acquisition and knowledge representation are so well described and documented in the literature, attesting to the detail with which these problems are being addressed (Buchanan, 1982; Buchanan & Shortliffe, 1984; Hayes-Roth, Waterman, & Lenat, 1983a; Kulikowski, 1980). With the emergence of artificial intelligence in nursing, a similar focus on issues related to knowledge acquisition and representation can be observed (Abraham, 1986; Abraham & Krowchuk, in press; Abraham & Schultz, 1986; Abraham, Schultz, Ozbolt, & Swain, 1984a, 1984b; Grosso & Abraham, 1987; Laborde, 1984; Ozbolt, 1986; Ozbolt, Schultz, Swain, & Abraham, 1985; Ryan, 1983).
Principal components extraction by autoassociative feed-forward networks

A methodology for testing the ability of autoassociative, feedforward, backpropagation networks to extract the principal components from a training set is described. Some simple examples, treated analytically and validated by numerical trials, suggest that such behavior may be typical. It is hypothesized that N-H-N autoassociative networks tend naturally to discover principal components in pattern sets subject to mild constraints. It seems probable that the time required by the network to extract good approximations of the principal components is short compared to the time that might be spent trying to overfit the patterns and that the neural net method might be competitive with the classical procedure in real-time adaptive processing applications. >
Effects of Driver and Secondary Task Characteristics on Lane Change Test Performance

The main objective of this study was to examine the sensitivity of the Lane Change Test LCT as proposed by International Organization of Standardization by evaluating LCT performance between primary and dual-task conditions in simulated driving conditions. The study involved four different secondary tasks that involved tracking, visual search, memory, and data entry, each under two different difficulty levels. The primary task involved a series of lane changes on a three-lane straight roadway where the actual lane change trajectory was compared with a normative model of the trajectory. Thus, the lane change performance was measured by the mean deviation of the actual driving trajectory from the normative trajectory. Twenty-four participants within three age groups 25-34, 35-45, and >55 years and equally distributed between male and female took part in the study. Thus, the study also investigated the effect of age and gender on driving performance. The results showed that secondary tasks that require visual attention and psychomotor coordination deteriorated driving performance the most, whereas tasks that required memory scanning and utilization of the auditory modality least affected driving performance. The study also found differences in LCT performances with respect to three different age categories and gender. © 2012 Wiley Periodicals, Inc.