cssi/SciSciGPT-SciSciNet huggingface dataset:
Characterization of the physical states in dual-resonance models

In the framework of dual-resonance models we derive the necessary conditions that the physical states on the mass shell have to satisfy. The orthogonality with the spurious states is required. By using these conditions we show that the first «daughter» is empty, while the second daughter contains at least three particles for each level (N>4). The first three excited levels are analysed in some detail.
More Single-Regime Models

This chapter presents a few more car-following models, including the Newell nonlinear model, the Newell simplified model, the intelligent driver model (IDM), and the Van Aerde model. These models not only capture the essence of car-following behavior but also aggregate to sound macroscopic behavior.
Dynamic Systems Theory and Sociocultural Theory: Some Connections and Distinctions

Both Dynamic Systems Theory and Sociocultural Theory consider second language development to be complex and dynamic, taking place through change across time. However, each has a different theoretical/methodological perspective, the former focusing on this process primarily as interconnected self-organizing systems and the latter as tied to the psychological development of consciousness as derived through experience across cultural historical contexts of activity. Nonetheless, there are shared elements that deserve recognition and consideration, particularly as regards future research.
Evaluating robust features on deep neural networks for speech recognition in noisy and channel mismatched conditions.

Deep Neural Network (DNN) based acoustic models have shown significant improvement over their Gaussian Mixture Model (GMM) counterparts in the last few years. While several studies exist that evaluate the performance of GMM systems under noisy and channel degraded conditions, noise robustness studies on DNN systems have been far fewer. In this work we present a study exploring both conventional DNNs and deep Convolutional Neural Networks (CNN) for noiseand channel-degraded speech recognition tasks using the Aurora4 dataset. We compare the baseline mel-filterbank energies with noise-robust features that we have proposed earlier and show that the use of robust features helps to improve the performance of DNNs or CNNs compared to melfilterbank energies. We also show that vocal tract length normalization has a positive role in improving the performance of the robust acoustic features. Finally, we show that by combining multiple systems together we can achieve even further improvement in recognition accuracy.
The sensitivity of aplysia giant neurons to changes in extracellular and intracellular PO2.

The effects of oxygen on the excitability of neurons have been studied in various groups of animals (Chalazonitis and Sugaya, 1958; Eccles et al, 1966; Chalazonitis, 1968; Kerkut and York, 1969; Steefin, 1975). However, the difficulty in recording intracellular PO2 (I · PO2) has prevented gathering of essential information concerning the effects of I · PO2 on oxidative processes and on the bioelectric phenomena of neurons. Since many giant neurons in the Aplysia abdominal ganglion are easily identifiable, stable for several days and can be penetrated with newly improved PO2 microelectrodes, we have employed them in a study of neuronal oxygen sensitivity. Chalazonitis has shown the effects of oxygen on the properties of the neuronal membrane in Aplysia by recording simultaneously, their bioelectrical properties and their I · PO2 by spectrophotometry. In the present study, we have confirmed his results of hypoxic effects on change in membrane potential and spontaneous activity.
Future and Advanced Concepts for the Powered Prosthesis

Future and advanced concepts facilitate considerable opportunity for the powered prosthesis. Since the powered prosthesis constitutes a mechatronic system, many other trends of industry, science, and engineering are anticipated to provide technological advance on the system, subsystem, and component level. Currently powered prostheses are equipped with localized wireless connectivity, and this capability can be augmented to Internet connectivity through a smartphone or portable media device. Synergy with the Internet of Things is envisioned to substantially advance the adaptive capacity of the powered prosthesis much to the likeness of the plasticity of and intact lower limb. Remote tele-rehabilitation is projected to enable unique therapy opportunities while alleviating implied logistic constraints inherent with traditional therapy sessions. Another advanced concept is the increasing significance of 3D printing. 3D printed materials are predicted to eventually attain property characteristics, such that they could be incorporated for structural elements of the prosthesis. Image scanning techniques may be applied to emulate skeletal and cosmetic features of the intact lower leg for 3D printing. In summary many opportunities exist regarding advances for prosthetic technology.
“Affirmative action is reverse racism”: The myth of merit

But Americans of all races and creeds, men and women, are disgusted with the system of reverse discrimination. Former Governor of California, Pete Wilson At the core of our shared belief in the American Dream is the assumption that basic qualities, valued widely in American society, will allow any individual to prevail. Pull yourself up by your own bootstraps. Hard work, determination, persistence, and dedication render any playing field level, goes the familiar narrative. It stands to reason, then, that those who do not succeed have only themselves to blame. The industrious rise through force of their own effort while the lazy founder on the rocks of failure because they lack the fundamental characteristics required for success. This is a dominant narrative in America. How, then, does the controversial, often misunderstood principle of affirmative action fit into this narrative? Cherished narratives of this sort are tricky and full of baggage that encumbers our ability to think through social realities and policies. We often respond with a kind of reflex when something challenges our assumptions, and often we do not examine all the premises that underlie either our assumptions or the new challenge. Affirmative action is such a challenge, and it goes to the heart of some basic, if mythic, narratives that explain and govern our lives. A number of dangerous myths we live by and half-truths tend to obscure the real meanings of affirmative action and its potential to make the American dream an actuality.
The Context of Italian Politics

Among the larger industrial states of Western Europe, Italy possesses certain unique characteristics. It has become one of the world’s ten leading industrial powers, yet the southern half of Italy is relatively underdeveloped and lags far behind the rest of the country—to say nothing of Western Europe—in per capita income. It has achieved spectacular social and economic progress since World War II, yet the former Italian Communist Party, which in 1991 adopted the name Democratic Party of the Left (Partito Democratico di Sinistra—PDS), is the strongest Communist or ex-Communist Party in Western Europe, stronger in electoral terms now than it was in 1946 and relatively more powerful than Communist parties in such less prosperous societies as Spain, Portugal, and Greece. Italy has attained a high degree of modernization in its economic structures, yet it is burdened with an antiquated, inefficient bureaucratic apparatus. In short, Italy presents a dramatic contrast between rapid economic and social change on the one hand and the survival of anachronistic regional imbalances, political cleavages, and administrative deficiencies on the other. Moreover, it has become evident that longstanding rumors of widespread corrupt practices were substantially true and that corruption has come to permeate every level of the Italian political system. Thus the Italian polity has come to lag ever farther behind the Italian economy. This political lag characterizes a dangerous transitional period, which Italy is now traversing on the road to becoming a stable and modern democracy.
Dynamic Blood Flow Control in Heart

Perfusion of the heart by blood is essential for the maintenance of physiological function. Published experiments and investigations by others reveal that the maximum AV O2 difference that can be achieved in heart is always observed between the coronary arteries and the venous outflow at the coronary sinus over the full range of blood flow (∼five fold) that is achieved. If so, exquisite matching of blood flow and O2 consumption must exist even at the smallest unit of perfusion. How does such tight control occur? We have examined the hypothesis put forward for the brain to determine if, in principle, it could work in heart. Nelson and colleagues have suggested that electrical activity could be a primary regulator of blood flow in the brain. Increased neuronal activity would lead to an increase in K+ efflux that would bathe endothelial cells which possess inward rectifier potassium channels (Kir). Activation of Kir could lead to hyperpolarization given the N-shaped Kir current-voltage (IV) relationship that we have observed. In the current study, we examined human microvascular endothelial cells from heart (HMVEC-C) in culture to determine how they responded to elevated [K+]o. We found that extracellular increases of K+ (from 5 mM to 15 mM) cause HMVEC-C hyperpolarization. This K+-induced membrane hyperpolarization is dependent on Kir activation as evidenced by its blockade by extracellular Ba2+. These findings suggest that cardiac electrical activity could contribute to K+-dependent hyperpolarization of the endothelial cells that could hyperpolarize the pre-capillary sphincter smooth muscle cells locally and thereby contribute to activity-dependent blood flow control.
Estimating the Corrective Tax for Goods whose Consumption Affects the Consumer’s Health

Taxing goods whose consumption has an adverse impact on the consumer’s health appears to be gaining support. But the social benefit from taxes on these goods is debatable. This paper considers what the corrective tax on such a good is and applies this theory to one good whose health effects are well established. More specifically, we produce a formula for computing the corrective tax on a good whose consumption may adversely affect the health of the consumer, and then use this formula to calculate the corrective tax for one such good, cigarettes.
Lethality Assessment Protocol: Police Perceptions of a Domestic Violence Intervention

This exploratory, qualitative research study examined the attitudes and barriers police officers identified in successful implementation of the lethality assessment protocol (LAP), a collaborative ...
Transformative Leadership: Lessons Learned Through Intergenerational Dialogue

The purpose of this article is twofold. First, it sheds light on an intergenerational leadership process experienced by two African American women. This piece is a leadership story situated within ...
Pre-operative corticosteroid injections improve functional outcomes in patients undergoing arthroscopic repair of high-grade partial-thickness rotator cuff tears.

Background Subacromial corticosteroid injections (CSI's) are a common non-surgical treatment for rotator cuff tears. Few studies have assessed the effects of pre-operative CSI's on postoperative functional outcomes. Methods A retrospective analysis was conducted of 132 patients with high-grade, partial-thickness rotator cuff tears (PTRCT's). The subjects were divided into two groups based on whether they received a CSI or not. The CSI group was further divided into three subgroups based on when they received a pre-operative injection: 0-3 months, 3-6 months, >6 months before surgery. The Visual Analog Scores (VAS), American Shoulder and Elbow Surgeon scores (ASES), and Constant scores were recorded prior to surgery and at a one-year post-operative follow-up appointment for each subject. Results Patients who received a pre-operative CSI (n=92) improved significantly more than the non-injection group (n=40) in all outcome measures. The 0-3 months injection subgroup experienced a significant increase in ASES and Constant score (p=0.019 and 0.014, respectively) compared to the other two subgroups, but the VAS score decrease only trended toward significance (p=0.091). The sample as a whole experienced significant improvement in all three outcome measures. Conclusion Patients undergoing arthroscopic repair of a high-grade PTRCT may benefit from a pre-operative CSI 0-3 months before surgery. Level of evidence IIb.
Madness as method: on Locke’s thought experiments about personal identity

ABSTRACTJohn Locke is famous for popularizing the method of the philosophical thought experiment in discussions of personal identity; the cases introduced in the second edition of An Essay Concerning Understanding (1694) are still employed by contemporary philosophers. Here I argue that Locke’s method is nonetheless importantly different from later efforts in ways that can help us better appreciate his larger projects. Rather than pumping the reader’s intuitions in support of his preferred account, Locke’s thought experiments serve to illustrate common errors in assessments of identity that he sees as particularly prevalent and problematic. Locke defends his idea of ‘person’ otherwise, through what I call his ‘lived experiments’: observations about linguistic usage that serve to illustrate the term’s role in practical reasoning. I focus especially on Locke’s example of the forensic status of the madman. Examples like these do not, for Locke, demonstrate the intuitiveness of his analysis, but rather bolste...
Ion Channels in Epithelial Cells

Ion channels in epithelial cells serve to move ions, and in some cases fluid, between compartments of the body. This function of the transfer of materialis fundamentally different from that of the transfer of information, which is the main job of most channels in excitable cells. Nevertheless the basic construction of the channels is similar in many respects in the two tissue types. This chapter reviews the nature of channels in epithelia and discusses how their functions have evolved to accomplish the basic tasks for which they are responsible. I will focus on three channel types: epithelial Na + channels, inward-rectifier K + channels, and CFTR Cl − channels. To appreciate the biological roles of these channels, it is necessary to consider the basic structure of an epithelial cell. These cells separate the major body fluid compartments from those which are essentially in contact with the outside world, including those fluids of the urinary tract, GI tract, and sweat. In the lung, epithelial cells separate the body from an air space, with a thin layer of fluid in between. All epithelia form layers of cells that are joined by so-called tight junctions. These junctions consist of an extracellular caulking material that helps to seal the layer and prevent material from leaking between the cells. The cells therefore have two very distinct membrane surfaces: one in contact with the internal body compartments (i.e., the interstitial fluid) and the other in contact with the external fluids. These are called the basolateral and apical membranes, respectively. A basic tenet of epithelial biology, originally emphasized by Ussing and colleagues (Koefoed-Johnsen and Ussing, 1958), is that the transport properties of these two membranes are very different. It turns out that many of the channels and other transport proteins that are specialized to epithelial cells reside in the apical cell membrane in contact with the urine, the intestinal contents, etc. while the transporters that are shared with other cells in the body are often expressed in the basolateral membranes. Epithelial Na + channels reside in the apical membranes of epithelia in the
Martensite Habit Plane in Quenched Ti-Mn Alloys

Investigation of martensite habit plane in water-quenched Ti-Mn alloys was carried out in the range of manganese contents between 4.35 and 5.25 pct. On the basis of 22 measurements, the poles were observed to fall into two groups, indicating the existence of two habit planes. The Miller indices of the poles close to these two groups were found to be β and β.
Isolating the effects of surface roughness versus wall shape in numerically optimized, additively manufactured micro cooling channels

Abstract Metal-based additive manufacturing is a disruptive technology with the capability to transform industries. The increased design space the technology offers is enticing to designers, who are given an opportunity to develop components that exceed prior performance levels; optimization tools can be used to provide guidance. However, the nature of surface roughness in additively manufactured parts is highly irregular, and computational models generally cannot properly capture the surface morphology. How, then, can current numerical tools predict the performance of additively manufactured components, or aid designers in developing products that meet their needs? The current study aims to provide insight into the current capabilities of both design tools and the additive manufacturing process for microchannels intended for cooling components. A commercially-available optimization scheme was used to improve the design of four microchannel cooling configurations. These optimized geometries were printed using a metal-based additive manufacturing process; only some objective functions were achieved experimentally. In the current study, the same optimized geometries were printed using a stereolithography process, which built smooth channels as simulated in the optimization scheme. Experiments were performed to gather friction factor data, and results showed that the design intents were largely validated. Analyses of the metal test coupons alongside the plastic coupons showcase the direct effects of surface roughness: the influence of surface roughness on the performance of the channels was predominantly tied to the goal of the shape change.
Classification of Meteorites

The purpose of a classification is to group together related objects in order to facilitate comparative investigations. A classification should consist of as few categories as possible without forcing together objects for which the evidence of a relationship is inadequate. The subdivision of categories is good insofar as it is justified by sound data. Although it is impossible to avoid the occasional placement of potentially related objects in separate categories, one should attempt to avoid implying that differences between such objects are greater than they really are.
Equine fasting hyperbilirubinemia.

It appears that different mechanisms responsible for fasting hyperbilirubinemia may be operative in different mammalian species (and subspecies). An increase in bilirubin production does not seem to occur in the horse, but a decrease in the hepatic uptake of bilirubin has been supported by a number of studies. Even though the delay in plasma elimination could also result from a decrease in hepatic blood flow, this possibility does not seem to play a major role since the hepatic uptake of compounds with low intrinsic hepatic clearance (e.g., ICG and bilirubin) appear to be affected more during fasting than those with higher clearances (e.g., BSP, bile acid, antipyrine, acetaminophen, and lidocaine) (Table I). Other possibilities such as a decrease in the affinity of hepatocellular membrane carriers involved in the uptake of these compounds or altered content of intracellular proteins involved in cellular transport or storage of bilirubin have not been investigated in horses. Competition with free fatty acids for these carrier-mediated events seems likely, particularly because horses and ponies experience high degrees of hyperlipidemia during fasting. However, studies that have explored the competition hypothesis, while not entirely negative, do not fully support it as being the sole mechanism responsible for this phenomenon. Hepatocellular UDPGT activities have not been adequately investigated in horses, but it is apparent that intraduodenal infusion of glucose is effective in reducing fasting hyperbilirubinemia and also in increasing biliary bilirubin excretion. It therefore seems possible that UDP-glucose and UDPGA levels in the livers of horses could be reduced during fasting, thus resulting in substrate depletion for the conjugating enzymes. As pointed out by Freedland et al. (1991), it is also possible that the horse, like the Bolivian squirrel monkey, might also have a relatively high apparent Km and low Vmax for UDPGT, thus resulting in high steady-state levels of plasma bilirubin, particularly during fasting. Although little is known about the cause of equine fasting hyperbilirubinemia and the subtle factors that may be modulating slight changes in the production, hepatocellular uptake, binding, conjugation, and/or biliary excretion of this pigment, it is known that it can be rapidly reversed by refeeding native hay. Perhaps one direction for future research could point toward more fully exploring what aspects of feeding are responsible for reversing this intriguing physiological phenomenon.
A domain-independent framework for effective experimentation in planning

Abstract This papers develops a general method for acquiring domain knowledge for planning by experimenting with their environment. When the expectations suggested by the domain knowledge and the observations differ, there is need and opportunity for learning. Since there are usually several possible ways to correct the domain, the system must experiment to gather additional information. This paper describes how to exploit the characteristics of planning domains in order to search the space of plausible hypotheses without the need for additional background knowledge to build causal explanations. Common features of planning domains are used in our system as heuristics to identify the most plausible hypotheses and avoid costly experiments. This work has been implemented in the PRODIGY planning architecture.
High-Order Schemes for Multi-Dimensional Hamilton-Jacobi Equations

We are interested in high-order numerical approximations for the solution of multi-dimensional Hamilton-Jacobi (HJ) equations of the form $$ {{\phi }_{t}} + H(\nabla \phi ) = 0,\quad x = ({{x}_{1}}, \ldots {{x}_{d}}) \in {{\mathbb{R}}^{d}}. $$ Here, H is the Hamiltonian, which we assume depends on ∇ϕ and possibly on x and t. The main difficulty in approximating the solutions of HJ equations is the discontinuous derivatives that develop in the solution in finite time even when the initial data is smooth. From an analytical point of view, solutions of HJ equations past the discontinuity are treated via the machinery of viscosity solutions (see [3, 4, 11] and the references therein). As far as the numerics is concerned, the first significant result were the converging first-order approximations by Souganidis [18]. High-order upwind methods, that are based on the ENO reconstruction of Harten et al [6], were introduced by Osher, Sethian and Shu [16, 17]. Jiang and Peng combined the Weighted ENO (WENO) interpolant [8, 14] with a monotone fiux obtaining the upwind-WENO schemes for HJ equations in [7].
Adenosine-Derived 5′-α-Halo Thioether, Sulfoxide, Sulfone, and (5′-Halo)Methylene Analogues. Inhibition of S-Adenosyl-L-Homocysteine Hydrolase

S-Adenosyl-L-methionine is the principal methyl group donor in a variety of metabolic pathways. The byproduct of this process, S-adenosyl-L-homocysteine (AdoHcy), is a potent feedback inhibitor of methyltransferase enzymes.1 S-Adenosyl-L-homocysteine hydrolase (AdoHcy hydrolase) catalyzes the hydrolysis of AdoHcy (1) to adenosine (Ado, 4) and L-homocysteine (Hcy) via a reversible oxidation, elimination, Michael addition, reduction mechanism1-3 (see Scheme 1). Since it is crucial for continuing metabolism to remove intracellular AdoHcy in order for enzymatic methylation to proceed, inhibition of AdoHcy hydrolase presents a rational target for anticancer and antiviral chemotherapy.3b We hypothesized that adenosine 5′-α-halo thioethers or their oxidized analogues might function as mechanism-based inhibitors of AdoHcy hydrolase if they were bound and converted into inhibitory species by the oxidation/elimination processes.4 It had been demonstrated that 4′,5′-didehydro-5′-deoxyadenosine [9-(5-deoxy-s-D-erythro-pent-4-enofuranosyl)adenine, 6] was accepted as an alternative substrate by AdoHcy hydrolase and converted into Ado and AdoHcy.2,5 Therefore, we also targeted 5′-halo analogues of 6 as potential mechanism-based inhibitors with adenosine 5′-α-halosulfoxides as precursors. We now summarize our syntheses of 5′-α-halo thioethers, sulfoxides, and sulfones from 5α-S-(alkyl or aryl)-5′-thioadenosines; thermal syn conversions of diastereomeric sulfoxides into 5′-halomethylene analogues of 6; stereochemical determinations by X-ray crystallography and 19F and 1H NMR spectroscopy; and time-dependent inactivation of AdoHcy hydrolase.
Antigen-Driven Lymphomagenesis

Chronic antigenic stimulation has been postulated to play a central role in the pathophysiology of Non-Hodgkin lymphoma. Mucosa-associated lymphoid tissues or MALT lymphoma of the stomach and its association with Helicobacter pylori is one of the most well studied examples of this phenomenon. Furthermore, other infectious and noninfectious entities have been described to produce monoclonal lymphocyte proliferation with resultant malignant lymphoproliferative ­disorders. Among these are Chlamydia psittaci, hepatitis C virus infection, rheumatoid arthritis, systemic lupus erythematosus, Sjogren disorder, and Hashimoto thyroiditis. This review focuses on these entities and summarizes the available data which associates these conditions with the development of malignant lymphoma.
Collaborating with Digital Natives on Digital Citizenship

This paper will explore how universities (through their academic departments, technology offices, and student engagement initiatives) can collaborate with students, who are digital natives, on practicing and expanding digital citizenship within the campus community. This presentation and paper will provide research-based best practices that can be implemented without creating an additional burden on faculty, staff, and students.
Teaching methods used by internal medicine residents on rounds: what works?

Background The specific teaching methods used by internal medicine residents on walk rounds are unknown. Objectives 1) To characterize in real time the specific teaching methods used by internal medicine residents on rounds and 2) to identify attributes of successful resident teaching on rounds. Materials and methods We conducted a prospective mixed-methods study on inpatient medical services at a single academic medical center from September 2016 to January 2017. Participants were internal medicine residents (postgraduate year [PGY]-1, PGY-2, and PGY-3) and attending physicians. Teachers were PGY-2 and PGY-3 residents, and learners were PGY-1 residents. Residents' teaching on rounds was observed and characterized according to resident demographics, specific teaching methods, and length of time. Participants completed a survey with Likert scale and free-text questions. Results and conclusion Among 136 surveys across 28 separate teaching encounters, we noted that PGY-3 residents' teaching was rated significantly better than PGY-2 residents' teaching. Teaching lasting >1 minute was rated significantly better than teaching lasting <1 minute. Free-text responses emphasized the value of immediate clinical relevance, citing published evidence, conciseness, clarity, and pertinence to the patient. Our findings may help guide internal medicine residents aiming to teach better on rounds and inform further research into specific resident teaching methods.
Expression and Roles of the Immunoglobulin Superfamily Recognition Molecule Sidekick1 in Mouse Retina

Processes of >100 types of interneurons (bipolar and amacrine cells) and projection neurons (retinal ganglion cells, RGCs) form specific and stereotyped patterns of connections in the inner plexiform layer (IPL) of the mouse retina. Four closely related homophilic immunoglobulin superfamily recognition molecules (Sidekick [Sdk] 1, Sdk 2, Dscam, and DscamL1) have been shown to play roles in patterning neuronal arbors and connections in chick retina, and all but Sdk1 have been shown to play related roles in mice. Here, we compare patterns of Sdk1 and Sdk2 expression in mouse retina and use genetic methods to assess roles of Sdk1. In adult retina, 3 neuronal types express sdk1 but not sdk2 at detectable levels, 5 express sdk2 but not sdk1 and 3 express both. Patterns of gene expression and protein localization at or near synapses are established during the first postnatal week. Dendrites of amacrine cells and RGCs that express sdk1 but not sdk2 arborize in the same narrow stratum in the center of the IPL. In the absence of Sdk1, this laminar restriction is degraded. Overexpression of sdk1 in developing cells that normally express sdk2 reorients their dendrites to resemble those of endogenously Sdk1-positive cells, indicating that Sdk1 plays an instructive role in patterning the IPL. Sdk1 fails to affect arbors when introduced after they are mature, suggesting that it is required to form but not maintain laminar restrictions. The effect of ectopically expressed sdk1 requires the presence of endogenous Sdk1, suggesting that the effect requires homophilic interactions among Sdk1-positive neurites. Together with previous results on Sdk2, Dscam, DscamL1, as well as the related Contactins, our results support the idea that an elaborate immunoglobulin superfamily code plays a prominent role in establishing neural circuits in the retina by means of tightly regulated cell type-specific expression and homophilically restricted intercellular interactions.
Potential of Exoskeleton Technologies to Enhance Safety, Health, and Performance in Construction: Industry Perspectives and Future Research Directions

Work-related musculoskeletal injuries and disorders remain an important problem in the construction industry. Exoskeletons are an emerging wearable technology that assists or augments a user’s phys...
The end of artefacts

Bill Phillips celebrates a beautiful reformation of the metric system, by which scientists measure the physical world, coming into effect on World Metrology Day, 20 May 2019.
Electrochemical Studies of Selected Lanthanide and Californium Cryptates.

Efforts to quantitatively reduce CfIII → CfII in solution as well as studies of its cyclic voltammetry have been hindered by its scarcity, significant challenges associated with manipulating an unu...
Self-Regard in Pastoral Ministry: Self-Compassion versus Self-Criticism in a Sample of United Methodist Clergy:

Pastoral ministry is a demanding and stressful vocation, and the empirical and anecdotal literature on ministry has often emphasized this negative outlook. More recent work, however, has shifted to...
Patterns of Healthcare Discrimination Among Transgender Help-Seekers.

Introduction Affirmative health care is imperative to address health and mental health disparities faced by transgender communities. Yet, transgender help-seekers experience discrimination that precludes their access to and participation in care. This study uses latent class analysis to examine patterns of healthcare discrimination among transgender help-seekers. Predictors of class membership are investigated to identify subpopulations at highest risk for healthcare discrimination. Methods Data were obtained from the 2015 U.S. Transgender Survey and analyzed in 2019. Ten healthcare experiences were included as latent class indicators. Latent class analysis and regression were performed in Mplus, version 8 to identify latent subgroups and examine the relationship between respondent characteristics and the latent classes. Results The final sample included 23,541 respondents. A 3-class model fit best: Class 1 experienced overt discrimination and interfaced with providers with limited trans-competence; Class 2 did not experience healthcare discrimination or report issues related to providers’ trans-competence; and Class 3 did not experience discrimination but had providers with low trans-competence. Transmen and respondents who were out as trans to their providers and reported psychological distress, suicidal thoughts, and disabilities were more likely to be members of Class 1 or 3 than Class 2. Conclusions Experiences of healthcare discrimination are not homogeneous across transgender help-seekers. Predictors of the latent classes indicated that transgender help-seekers holding an additional marginalized identity may be at higher risk for healthcare discrimination or care from providers with limited trans-competence. Targeted engagement and education interventions might improve these transgender help-seekers’ access to and connections with care.
Does the location of short-arm cast univalve effect pressure of the three-point mould?

Abstract Purpose Forearm and distal radius fractures are among the most common fractures in children. Many fractures are definitively treated with closed reduction and casting, however, the risk fo...
Knowledge, attitudes, and practices related to human papillomavirus vaccination among college students in a state university: Implications for nurse practitioners

Background Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and disproportionately affects adolescents and young adults. Although a safe and efficacious vaccine is available, many college students are unimmunized against HPV. Most students presenting to college health centers are within the age range for catch-up immunization, giving nurse practitioners (NPs) in this setting an opportunity to increase vaccination rates. More information is needed about college students' HPV knowledge, attitudes, and vaccination uptake so that NPs can make effective vaccine recommendations to this population. Purpose To examine (a) Knowledge and attitudes about HPV and its vaccine; (b) HPV immunization practices; and (c) factors associated with HPV knowledge, attitudes, and vaccination among college students in a US university. Methods This cross-sectional quantitative study collected data from participants in a state university student health center. Data collected included knowledge, attitudes, and practices about HPV and its vaccine from 627 students. Results Participants had a moderately low HPV knowledge but positive attitudes toward HPV and its vaccine. Participants with a higher level of HPV knowledge were US born, health-related majors, married or divorced, and had positive attitudes. Higher HPV knowledge, vaccine uptake, and a family history of cervical cancer were associated with positive attitudes. Predictors for vaccine uptake include being a health-related major and positive vaccine attitudes. Implications for practice The results of this study help NPs, registered nurses, and other health care providers make effective HPV vaccine recommendations to college students. Students with positive HPV attitudes can serve as peer educators to increase HPV vaccination awareness in this population.
Ischemic stroke and cerebral venous sinus thrombosis in pregnancy

Maternal ischemic stroke and cerebral venous sinus thrombosis (CVST) are dreaded complications of pregnancy and major contributors to maternal disability and mortality. This chapter summarizes the incidence and risk factors for maternal arterial ischemic stroke (AIS) and CVST and discusses the pathophysiology of maternal AIS and CVST. The diagnosis, treatment, and secondary preventive strategies for maternal stroke are also reviewed. Special populations at high risk of maternal stroke, including women with moyamoya disease, sickle cell disease, HIV, thrombophilia, and genetic cerebrovascular disorders, are highlighted.
Exploring Elementary Student Perceptions of Experiential Learning Within Critical Service-Learning:

Background: Critical service-learning provides an opportunity for culturally sustaining and experiential learning across a variety of contexts. This study took place alongside a larger study examin...
Impact of Global Health Electives on Neurology Trainees

We surveyed neurologists who completed a global health experience as residents or fellows to assess the impact of the experience. A total of 100% (n = 72) would recommend the experience to others. Most reported improved clinical (86%) and examination (82%) skills. All gained an understanding of different health care systems, and 83% reported deeper commitment to underserved populations. A total of 41 participants (57%) reported more judicious use of resources upon return to the United States. Global health electives had a positive impact on neurology trainees. More attention to the host country perspective and predeparture training may help inform program structure and participant expectations in the future. ANN NEUROL 2021;89:851-855.
An evidence-based approach to monitoring serum sodium in patients following non-pituitary cerebral neoplasm resection

Abstract Object It is common for many neurosurgical services to routinely order daily laboratory studies on all inpatients. Here we investigate whether daily post-operative sodium (Na) is predictive of seizures experienced by patients admitted for non-pituitary tumor resection. Methods Three databases were constructed over a one-year period; a retrospective database inclusive of 916 inpatients admitted to the UCLA neurosurgery service, a prospective database of 644 inpatients admitted to the UCLA neurosurgery service, and a readmission database of 139 patients that were either readmitted or evaluated in the Emergency Department within 30 days of discharge. Sodium levels during admission were recorded in the retrospective database and the probability of a ≥ 5 mEq/L drop in Na over the first five days was calculated. The incidence of post-operative seizures was recorded in the prospective and readmission cohorts. For each seizure event, the diagnosis category and Na level were recorded. Finally, a subset of patients with borderline (130–134 mEq/L) Na levels at discharge were scheduled for outpatient Na checks to explore the safety of this practice. Results In the retrospective and prospective databases, the primary diagnosis of tumor was present in 227 (25%) and 149 (23%) patients respectively. Patients with a primary diagnosis of tumor showed an overall positive skewness of 0.187, with a probability of ≥ 5 mEq/L drop in Na level of 6.5%. Ten patients experienced early, and three patients experienced late postoperative seizures. Na level was within the normal range in all patients with a primary diagnosis of tumor at the time of seizure. Of the patients discharged with borderline serum Na, serum Na normalized during outpatient follow-up in all who presented to the appointment. Conclusions There is a mild trend towards hyponatremia following non-pituitary tumor surgery. However, this mild trend towards hyponatremia following brain tumor surgery is not associated with an increased incidence of seizure in either the early or late setting. Further, this hyponatremia is self-resolved and does not require aggressive treatment or prolonged hospital stays.
Efficacy of clinical-grade human placental mesenchymal stromal cells in fetal ovine myelomeningocele repair

Abstract Background While fetal repair of myelomeningocele (MMC) revolutionized management, many children are still unable to walk independently. Preclinical studies demonstrated that research-grade placental mesenchymal stromal cells (PMSCs) prevent paralysis in fetal ovine MMC, however this had not been replicated with clinical-grade cells that could be used in an upcoming human clinical trial. We tested clinical-grade PMSCs seeded on an extracellular matrix (PMSC-ECM) in the gold standard fetal ovine model of MMC. Methods Thirty-five ovine fetuses underwent MMC defect creation at a median of 76 days gestational age, and defect repair at 101 days gestational age with application of clinical-grade PMSC-ECM (3 × 105 cells/cm2, n = 12 fetuses), research-grade PMSC-ECM (3 × 105 cells/cm2, three cell lines with n = 6 (Group 1), n = 6 (Group 2), and n = 3 (Group 3) fetuses, respectively) or ECM without PMSCs (n = 8 fetuses). Three normal lambs underwent no surgical interventions. The primary outcome was motor function measured by the Sheep Locomotor Rating scale (SLR, range 0: complete paralysis to 15: normal ambulation) at 24 h of life. Correlation of lumbar spine large neuron density with SLR was evaluated. Results Clinical-grade PMSC-ECM lambs had significantly better motor function than ECM-only lambs (SLR 14.5 vs. 6.5, p = 0.04) and were similar to normal lambs (14.5 vs. 15, p = 0.2) and research-grade PMSC-ECM lambs (Group 1: 14.5 vs. 15, p = 0.63; Group 2: 14.5 vs. 14.5, p = 0.86; Group 3: 14.5 vs. 15, p = 0.50). Lumbar spine large neuron density was strongly correlated with motor function (r = 0.753, p Conclusions Clinical-grade placental mesenchymal stromal cells seeded on an extracellular matrix rescued ambulation in a fetal ovine myelomeningocele model. Lumbar spine large neuron density correlated with motor function, suggesting a neuroprotective effect of the PMSC-ECM in prevention of paralysis. A first-in-human clinical trial of PMSCs in human fetal myelomeningocele repair is underway.
State-of-the-art surgery for ulcerative colitis

Ulcerative colitis (UC) is an autoimmune-mediated colitis which can present in varying degrees of severity and increases the individual’s risk of developing colon cancer. While first-line treatment for UC is medical management, surgical treatment may be necessary in up to 25–30% of patients. With an increasing armamentarium of biologic therapies, patients are presenting for surgery much later in their course, and careful understanding of the complex interplay of the disease, its management, and the patient’s overall health is necessary when considering he appropriate way in which to address their disease surgically. Surgery is generally a total proctocolectomy either with pelvic pouch reconstruction or permanent ileostomy; however, this may need to be spread across multiple procedures given the complexity of the surgery weighed against the overall state of the patient’s health. Minimally invasive surgery, employing either laparoscopic, robotic, or transanal laparoscopic approaches, is currently the preferred approach in the elective setting. There is also some emerging evidence that appendectomy may delay the progression of UC in some individuals. Those who treat these patients surgically must also be familiar with the numerous potential pitfalls of surgical intervention and have plans in place for managing problems such as pouchitis, cuffitis, and anastomotic complications.
Use of a perceived efficacy tool to evaluate the FallTIPS program

Background/objectives To assess nurses' opinions of the efficacy of using the FallTIPS (Tailoring Interventions for Patient Safety) fall prevention program. Design Survey research. Setting Seven adult acute-care hospitals in 2 hospital centers located in Boston and NYC. Participants A total of 298 medical-surgical nurses on 14 randomly selected units. Intervention Three-step FallTIPS fall prevention program that had been in use as a clinical program for a minimum of 2 years in each hospital. Measurements Fall Prevention Efficiency Scale (FPES), range 13-52; four-factorilly derived subscales: valued, efficiency, balances out and inefficiency; and 13 psychometrically validated individual items. Results Nurses perceived the FallTIPS fall prevention program to be efficacious. The FPES mean score of 38.55 (SD = 5.05) and median of 39 were well above the lowest possible score of 13 and scale midpoint of 32.5. Most nurses (N = 270, 90.6%) scored above 33. There were no differences in FPES scores between nurses who had only used FallTIPS and nurses who had previously used a different fall prevention program. Conclusion The nurses who used FallTIPS perceived that efficiencies in patient care compensated for the time spent on FallTIPS. Nurses valued the program and findings confirmed the importance of patient and family engagement with staff in the fall prevention process. Regardless of the fall prevention program used, organizations should examine staff perceptions of their fall prevention program because programs that are not perceived as being useful, efficient, and valuable will lead to nonadherence over time and then will not reduce falls and injuries. The recently developed FPES used in this study is a brief tool available for organizations to assess nurses' perceptions of the efficacy of their fall prevention program. Additional FPES research is needed with larger and more diverse samples.
Histopathology of brain tissue from patients with infantile spasms

This chapter reviews the patterns of neuropathologic abnormality encountered in cortical resections performed for the treatment of infantile spasms (ISS) in the broader context of the larger "universe" of neuropathology seen in the central nervous system of infants with this syndrome as well as older children with intractable epilepsy. Although destructive lesions (encephalomalacia), Sturge-Weber-Dimitri syndrome, and even neoplasms can cause ISS, its most common neuropathologic substrate is cortical dysplasia (CD), representing the result of aberrant neuronal migration to the neocortex from the germinal matrix. Ways to recognize CD morphologically and assess its severity are reviewed, as are special stains and immunohistochemical methods that may be useful in confirming the diagnosis. The similarity and relationship between (sporadic) CD and tubers of tuberous sclerosis are discussed. Future potentially fruitful research directions aimed at refining the clinicopathologic analysis of the role of CD in ISS and epilepsies of older children are briefly considered.
Automated oscillator macromodelling techniques for capturing amplitude variations and injection locking

We present a method for extracting comprehensive amplitude and phase macromodels of oscillators from their circuit descriptions. The macromodels are based on combining a scalar, nonlinear phase equation with a small linear time-varying system to capture slowly-dying amplitude variations. The comprehensive macromodels are able to correctly predict oscillator response in the presence of interference at far lower computational cost than that of full SPICE-level simulation. We also present an efficient numerical method for capturing injection locking in oscillators, thereby improving on the classic technique of Adler (1946) in terms of accuracy and applicability to any kind of oscillator. We demonstrate the proposed techniques on LC and ring oscillators, comparing results from the macromodels against full SPICE-like simulation. Numerical experiments demonstrate speed tips of orders of magnitude, while retaining excellent accuracy.
Image-Guided Telemedicine System via the Internet

This paper presents an Internet software application that is readily available and that can greatly affect practice. Any medical facility with Internet access can use this system to visually diagnose breast fine needle aspirates since the program is implemented as a Java applet and accessed remotely via the World Wide Web. The proposed system automatically indexes objects based on shape and groups them into a set of clusters, or prototypes. Queries are first compared to the set of prototypes and then to the objects in the most similar prototypes. In terms of dissimilarity, each query is performed based on shape, or possibly in combination with other features as size, radius, perimeter, area, smoothness, compactness, concavity, and concave points. Experimental results show that the system achieved satisfactory performance.