cssi/SciSciGPT-SciSciNet huggingface dataset:
The MRI signs of spinal arachnoid diverticula

Our goal was to find MRI signs of use for identifying a spinal arachnoid diverticulum. Three cases of spinal arachnoid diverticula, one extradural and two intradural, were examined on a 1.5 T imager. There was obvious mass effect on the adjacent structures in one case and increased signal intensity in the diverticulum on proton density- and T2-weighted images in two cases. Signal changes due to turbulent movement of the spinal fluid inside the diverticula were seen in all cases on sagittal fast spin-echo (FSE) proton density- and T2-weighted images; it was difficult to tell whether these signal changes imply a communication or are simply FSE artefacts. On contrast-enhanced studies, all cases showed partial enhancement inside the diverticula. There thus are four signs of diverticula: mass effect, the increased signal, signal void sign and partial enhancement; the last of these, the most reliable, has never been reported before.
A review of how magnetic resonance imaging can aid in case management of common pathological conditions of the equine foot

Summary Magnetic resonance imaging (MRI) has become a valuable tool for the diagnosis of a multitude of conditions previously grouped into the vague diagnosis of palmar heel pain based on the response to palmar digital nerve diagnostic analgesia. The use of MRI not only determines a specific pathological diagnosis of the numerous structures within the foot but also the findings of the MRI help direct treatment and rehabilitation protocols, as well as providing prognostic information. Common injuries include damage to the navicular apparatus, deep digital flexor tendon, arthropathy of the distal interphalangeal joint and desmopathy of the collateral ligaments of the distal interphalangeal joint. This article reviews common MRI abnormalities in the equine foot and how treatment can be directed by the findings. Medical and surgical treatment options, as well as shoeing and rehabilitation protocols, are also discussed in relation to MRI findings. Using MRI can help create a more individually tailored and case-specific treatment regimen, which can, in turn, promote a more positive outcome in equine cases.
Plug-through energy monitor for plug load electrical devices

We present a low-cost, plug-through energy monitor for ubiquitous electrical monitoring of plug load devices in buildings. Using a non-invasive inductive current sensing technique, the current through a plug load device is measured without a series sensing element that breaks the circuit. This enables slim profile hardware, and eliminates the series resistor power dissipation inherent in traditional current sensing implementations. Our device is fabricated using a standard PCB process with a BOM around $5, and an inductive sense coil is printed directly into the PCB. The prototype can be embedded into an outlet faceplate and easily retrofits onto any existing outlet for long-term measurement of AC power parameters. The sensor includes low-power wireless connectivity with a range of approximately 120 feet through multiple walls. Voltage and current signals are sampled at 1920 Hz for handling non-linear loads, and the measured noise floor is approximately 2.4W with 120 V RMS mains.
Anglo-American Land Law: Diverging Developments from a Shared History - Part I: The Shared History

This series of three articles describes the history of land law shared by the British and American legal systems, and how and why these legal traditions have diverged from each other in modern times. This Article - part 1 in this series - describes the emerging customs and laws regarding land rights among early inhabitants of Britain, and how succeeding invasions and occupation by Celtic, Roman, Germanic, and Norman peoples altered these customs and laws. The Article details the profound changes in land law worked by massive economic changes in early British society, including sociological occurrences such as the Black Death, and the adoption of laws, such as the Statute of Uses in 1536.
Information Security Capacity Building in Community-Based Organizations: Examining the Effects of Knowledge Transfer

Community-based organizations (CBOs) in the health and human services sector handle very sensitive client information, such as psychiatric, HIV testing, criminal justice, and financial records. With annual revenue often in the range $1 to $10 million, these organizations typically lack the financial, labor, and technical resources to identify and manage information security risks within their environment. Therefore, this paper proposes information security capacity building interventions facilitated by university collaborators as a means to transfer information security knowledge to CBO participants of a service learning course. The paper develops a theoretical model that examines how such an intervention may result in strengthened information security within participating CBOs.
Neuroscience and spinal cord injury: plasticity in the brain, in the spinal cord-and in our way of thinking

When the second half of the 20th century began, neuroscience seemed more a marketing buzzword than a term describing a new discipline—one that recognized that complex neural tissues and their functions could be understood only when the walls among biochemists, physiologists, anatomists, and others disappeared. Although frictions remain among the disciplines associated with neuroscience (especially when molecular biology is discussed), neuroscience offers all of us a lesson about the benefits of intellectual collaboration. When researchers work together, the impossible suddenly becomes possible, and there is less fear of heresy. As a result, we make room for new kinds of questions and the creative application of research methods, ones limited not by the training of individuals but by teams and financial resources. Since the founding of the Society for Neuroscience in 1970, the growth of knowledge about the nervous system has been remarkable. Ideas once thought to be inviolate now fall before new experimental paradigms. These paradigms provide insights that no one could have imagined …
REVISITING INTRAVENOUS INOTROPES: ARE THEY AS BAD AS WE THOUGHT IN REMATCH

In the 2001 Randomized Evaluation of Mechanical Assistance for the Treatment of CHF (REMATCH) trial a 48% decrease in all-cause mortality was seen in patients (pts) randomized to the HeartMate-VE vs. medical therapy (including inotropes). As a result, outpatient IV inotrope infusions have been
Quantum phases in Bose-Einstein condensate within ab-initio calculations

We use the Pair-Density Functional Theory (PDFT) to observe transition between different phases in Bose-Einstein condensate. Unlike for the Bose-Hubbard theory the pair correlation function is calculated exactly for signature of quantum phase transition.
A Unopette for Eosinophil Counts

The eosinophil Unopette containing a stable modified Pilot's stain has been evaluated in our laboratory. Excellent correlation was found by comparing the results obtained with the glass dilution pipettes. The advantages of the Unopette are accuracy, convenience, stability of diluent at room temperature, and disposability.
A Practical Probabilistic Graphical Modeling Tool for Weighing Ecological Risk-Based Evidence

ABSTRACTPast weight-of-evidence frameworks for adverse ecological effects have provided soft-scoring procedures for judgments based on the quality and measured attributes of evidence. Here, we provide a flexible probabilistic structure for weighing and integrating lines of evidence for ecological risk determinations. Probabilistic approaches can provide both a quantitative weighing of lines of evidence and methods for evaluating risk and uncertainty. The current modeling structure was developed for propagating uncertainties in measured endpoints and their influence on the plausibility of adverse effects. To illustrate the approach, we apply the model framework to the sediment quality triad using example lines of evidence for sediment chemistry measurements, bioassay results, and in situ infauna diversity of benthic communities using a simplified hypothetical case study. We then combine the three lines evidence and evaluate sensitivity to the input parameters, and show how uncertainties are propagated and ...
Lattice Programming and Consumer TheoryPart II: Comparative Statics with Many Goods

Antoniadou (2004a) laid the foundations of the methodology for using lattice programming to study comparative statics in the consumer problem. The definition of income effects gives rise to a class of partial orders called value orders. This paper carries the analysis further by showing how value orders can be constructed with many goods. The class of direct value orders are descriptively parsimonious value orders. The class of augmented direct value orders preserve this descriptive parsimony while being normatively more satisfactory. Comparative statics results for income effects and some cases of price effects are discussed with the aid of these partial orders and ensuing lattices. The analysis is global, with discrete changes, indivisibilities and non-binding budget constraints possible.
Problems and solutions in the interpretation of diagnostic tests

The interpretation of diagnostic tests has had a remarkable progress in recent years with a tendency towards a more clinical and patient-oriented perspective. Here we emphasize the limitations of using the dichotomy positive/negative testing or cut-off points for normality in many of our medical decisions. We also introduce alternative methods to interpret diagnostic tests, specially in unusual circumstances, i.e., in the development of new diagnostic tests that may be better than the accepted gold standard or when there is no gold standard. Finally we analyze the different interpretations of false negative results that may modify the interpretation of subsequent testing in a patient.
Prenatal prediction of autosomal dominant diseases by linkage studies: myotonic dystrophy

Remarkable progress in adapting specific chromosomal and biochemical tests to amniotic fluid samples has allowed intrauterine diagnosis for an increasing number of inherited conditions. However, the lack of any specific tests for autosomal dominant diseases, especially those affecting the nervous system and muscle, has precluded such prenatal evaluation in genetic counseling. Genetic linkage offers a potentially useful alternative approach to such diseases. The gene for a particular disorder must be closely linked to a genetic marker which can be analyzed in amniotic fluid or cells obtained in the second trimester of pregnancy. We have recently applied linkage studies to the prediction of myotonic dystrophy (Dm) during pregnancy. Dm is known to be closely linked to the secretor locus (Se) , which determines the secretion of ABH blood-group substances into saliva and other body fluids, including the amniotic fluid of the fetus. Only certain families will be suitable for this analysis: the affected parent must have thesecretor-positive phenotype and be heterozygous (Se/se) at the secretor locus; the coupling of the Dm allele to the Se or se allele must be determined; and the spouse must be either secretor-negative or heterozygous secretor-positive. Secretor genotypes can be inferred from secretor phenotypes of close relatives, including the fetus at risk. Unfortunately, these criteria will be satisfied in only 5-10 percent of couples at risk to transmit myotonic dystrophy. In suitable couples, however, linkage analysis can be quite helpful.
Increased Levels of Anaphylatoxin (C5a) and Bradykinin in End-Stage Renal Disease Patients on Maintenance Hemodialysis. Potential Relevance to Heparin Mediated Hemodynamic Responses

Abstract Besides the upregulation of inflammatory mediators, end stage renal disease (ESRD) patients maintained on hemodialysis are subjected to periodic exposure to heparin and contact activation due to procedural settings. Recently the presence of a heparin contaminant, namely hypersulfated chondroitin sulfate was linked with the adverse reactions and deaths observed in these patients (Kishmoto, et al. N J Med 2008). To validate this report we measured both the C5a anaphlatoxin and bradykinin levels in ESRD patients prior to and after maintenance hemodialysis. The control group comprised of 40 normal healthy individuals were included to establish the normal level of these mediators. A sandwich ELISA method utilizing a monoclonal antibody which is specific for human C5a and bradykinin were used in these studies. Both the C5a and bradykinin were elevated in pre-dialysis samples from ESRD patients (C5a: 3.2±0.6 ng/ml vs 14.2± 4.6 ng/ml, bradykinin: 6.4±1.8 ng/ml vs 9.3±2.4 ng/ml). Moreover, dialysis itself produced an increase in both the C5a and bradykinin levels. Moreover, the postdialysis samples were further increased, suggesting that dialysis and heparinization itself result in the up-regulation of these mediators. Supplementation of heparin to the plasma also resulted in the generation of both C5a and bradykinin. The plasma samples included in these studies represents patients who were not treateded with the contaminant heparin. Additional studies on in-vitro generation of these markers with contaminated heparin and the isolated contaminant showed that both of these triggered the generation of C5a and bradyknin. These results suggest that both C5a and bradykinin are up-regulated in ESRD patients and this level can be further augmented by dialysis and heparinization. Therefore, additional factors may have contributed to the complex adverse reaction profiles and deaths in patients administrated with contaminated heparin.
Primary Resistance to PD-1 Blockade Mediated by JAK1/2 Mutations.

Loss of function mutations in JAK1/2 can lead to acquired resistance to anti-programmed death protein 1 (PD-1) therapy. We reasoned they may also be involved in primary resistance to anti-PD-1 therapy. JAK1/2 inactivating mutations were noted in tumor biopsies of 1 of 23 patients with melanoma and in 1 of 16 patients with mismatch repair deficient colon cancer treated with PD-1 blockade. Both cases had a high mutational load but did not respond to anti-PD-1 therapy. Two out of 48 human melanoma cell lines had JAK1/2 mutations, which led to lack of PD-L1 expression upon interferon gamma exposure mediated by inability to signal through the interferon gamma receptor pathway. JAK1/2 loss-of-function alterations in TCGA confer adverse outcomes in patients. We propose that JAK1/2 loss-of-function mutations are a genetic mechanism of lack of reactive PD-L1 expression and response to interferon gamma, leading to primary resistance to PD-1 blockade therapy.
Pathways to Participation: Class Disparities in Youth Civic Engagement:

Recent research finds that there is a growing class gap in levels of civic engagement among young whites in the United States. Much of the literature on civic engagement focuses on individual– and ...
Concluding Thoughts on Media Representations of Higher Education: Anti-intellectualism and Other Themes

This chapter revisits the research questions posed in the first chapter to provide a comprehensive analysis of the media depiction of higher education based on the content of the previous chapters. In general, the representation is consistent across media and time. However, unlike the other media, video games and comic books offer a more positive view of the role of institutions and faculty suggesting that they can work to solve problems. The more common perception is that postsecondary institutions do not support, inspire, or promote students. Further, faculty use tenure to protect their bad behavior while students come to college to party. These anti-intellectual sentiments find expression across media and time. The chapter concludes with potential implications of this disparaging portrait of higher education.
Ethnicity, reception and the growth of American immigration

Deportation has always been a feature of the American political, social and economic discourse. A twin effect of immigration, deportation concerns who is granted the right to stay and who is remove...
Image navigation and registration performance assessment evaluation tools for GOES-R ABI and GLM

The GOES-R Flight Project has developed an Image Navigation and Registration (INR) Performance Assessment Tool Set (IPATS) for measuring Advanced Baseline Imager (ABI) and Geostationary Lightning Mapper (GLM) INR performance metrics in the post-launch period for performance evaluation and long term monitoring. IPATS utilizes a modular algorithmic design to allow user selection of data processing sequences optimized for generation of each INR metric. This novel modular approach minimizes duplication of common processing elements, thereby maximizing code efficiency and speed. Fast processing is essential given the large number of sub-image registrations required to generate INR metrics for the many images produced over a 24 hour evaluation period. This paper describes the software design and implementation of IPATS and provides preliminary test results.
Implementing TomoTherapy in a Community Setting

adiation oncology has witnessed a boom in technology over the past two decades. All these technologies have one objective: the delivery of higher radiation doses to a specific target while sparing the adjacent normal tissues. It is the subtle dose deliveries of these applications that distinguish one system from another: stereotactic radiosurgery (SRS), intensity modulated radiation therapy (IMRT), and imageguided radiation therapy (IGRT). Similar technology produced by multiple manufacturers can be confusing for community cancer programs. When one considers the high cost of new radiation oncology equipment, purchasing decisions become even more challenging. Most community cancer programs simply cannot afford every new technology, so physicians and administrators must perform thorough assessments of each system to decide which equipment is the best fit for their clinic and cancer patient needs.
Genome Sequence of a Newly Isolated F2 Subcluster Mycobacteriophage from the Black Belt Geological Region of Western Alabama.

ABSTRACT The bacteriophage Demsculpinboyz was discovered in a soil sample from the Black Belt region of Alabama using Mycobacterium smegmatis mc2155 as its host. The genome is 57,437 bp long and contains 116 protein-coding genes. It belongs to the F2 subcluster, which has only five other members.
The Intersection of Race and Gender Among Black American Adolescents

This study employed an exploratory sequential mixed-methods design to examine the intersection of race and gender among Black American adolescents, aged 11-19. The quantitative component (n = 344) used survey data to examine gender differences in peer-perpetrated and adult-perpetrated racial discrimination experiences, and no gender differences were evident. Qualitative data (n = 42) probed how males and females interpret discrimination experiences given the intersection of race and gender. Although the majority of participants believed that Black males and females have similar experiences, some believed that Black males face more racial discrimination. However, analyses revealed social disadvantages for Black females given that they report inappropriate comments and unwelcome hair touching and limited opportunities for interracial dating compared with Black males. [ABSTRACT FROM AUTHOR]
In an in-vitro model using human fetal membranes, α-lipoic acid inhibits inflammation induced fetal membrane weakening.

Abstract Introduction We established an in-vitro model for the study of human fetal membrane (FM) weakening leading to pPROM. In this model, granulocyte-macrophage colony-stimulating factor (GM-CSF) is a critical intermediate for both tumor necrosis factor-α (TNF; modeling infection/inflammation) and thrombin (modeling decidual bleeding/abruption)-induced weakening. Thus, inhibitors of FM weakening can be categorized as targeting GM-CSF production, GM-CSF downstream action, or both. Most progestogens inhibit both, except 17-α hydroxyprogesterone caproate which inhibits FM weakening at only one point, GM-CSF production. α-lipoic acid (LA), an over-the-counter dietary supplement, has also been previously shown to inhibit TNF and thrombin induced FM weakening. Objective To determine the point of action of LA inhibition of FM weakening. Methods FM fragments were mounted in Transwell inserts and preincubated with/without LA/24 h, then with/without addition of TNF, thrombin or GM-CSF. After 48 h, medium was assayed for GM-CSF, and FM fragments were rupture-strength tested. Results TNF and thrombin both weakened FM and increased GM-CSF levels. GM-CSF also weakened FM. LA inhibited both TNF and thrombin induced FM weakening and concomitantly inhibited the increase in GM-CSF in a concentration-dependent manner. In addition, LA inhibited GM-CSF induced FM weakening in a concentration dependent manner. Conclusions LA blocks TNF and thrombin induced FM weakening at two points, inhibiting both GM-CSF production and downstream action. Thus, we speculate that LA may be a potential standalone therapeutic agent, or supplement to current therapy for prevention of pPROM related spontaneous preterm birth, if preclinical studies to examine feasibility and safety during pregnancy are successfully accomplished.
The usefulness of various cytologic specimen preparations for PD-L1 immunostaining in non-small cell lung carcinoma.

Introduction Evaluation of programmed cell death ligand-1 (PD-L1) on formalin-fixed paraffin-embedded (FFPE) histologic specimens is required for immunotherapy with pembrolizumab in non-small cell lung carcinoma (NSCLC). A significant percent of patients may be diagnosed on cytology samples alone; however, FFPE tissue may not always be available. Here, we evaluated the feasibility of PD-L1 staining on a variety of cytologic preparations including conventional cell blocks (CB), cell-transfer cell blocks (CTCB), and direct smears. Materials and Methods We identified 30 NSCLC cytology cases that had PD-L1 status evaluated on a concurrent core needle biopsy. Papanicolaou-stained smears (PS) were reviewed and a moderately cellular smear was selected per case to prepare a CTCB. CTCB, CB, and PS (when available) were stained with PD-L1 22C3 and tumor proportion scores (TPS) were compared across all preparations with the concurrent core biopsies. Results Concordance of PD-L1 positivity in CB and PS versus core biopsy was high, 80% (12 of 15) and 94.4% (17 of 18), respectively. CTCB versus core biopsy concordance was lower in comparison, 62% (13 of 21) for PD-L1 positivity. Overall, TPS was lower in CTCB compared with CB and PS. Among the 3 preparations, CTCB and CB sections were easier to interpret as PS displayed various artifactual staining patterns. Conclusions In summary, our study demonstrates that CB and PS preparations are suitable surrogates for histologic FFPE tissue for determining PD-L1 status in NSCLC patients. CTCBs, on the other hand, show high discordance and are not optimal specimens. Pre-analytic factors in unconventional cytology preparations may need optimization and negative results should be interpreted with caution.
Simultaneous Longitudinal Examination of Hopelessness, Thwarted Belongingness, and Perceived Burdensomeness as Predictors of Suicide Ideation.

Objective Based on Beck's hopelessness model (Beck, Kovacs, & Weissman, Journal of the American Medical Association, 234, 1975, 1146) and Joiner's (Why people die by suicide, 2005, Harvard University Press, Boston, MA) interpersonal theory of suicide, this study simultaneously examined three cognitive risk factors (hopelessness, thwarted belongingness, and perceived burdensomeness) as predictors of suicide ideation. Method The study focused on high school and college students (ns = 192 and 142, respectively), assessed twice 4 months apart. Results When hopelessness, perceived burdensomeness, and thwarted belongingness were examined separately, each cognitive risk factor predicted future suicide ideation in both groups. When the three cognitions were tested simultaneously, none emerged as uniquely predictive of suicide ideation. A longitudinal, latent variable model suggested that a common factor underlying all three types of cognition significantly predicted suicide ideation. Furthermore, thwarted belongingness predicted both hopelessness and perceived burdensomeness over time. Conclusions Results suggest ways that aspects of Beck's and Joiner's theories complement each other and could be combined to yield a more comprehensive understanding of cognitive factors associated with suicide ideation.
Let’s call the whole thing off: evaluating gender and sex differences in executive function

The executive functions allow for purposeful, deliberate, and intentional interactions with the world—attention and focus, impulse control, decision making, and working memory. These measures have been correlated with academic outcomes and quality of life, and are impacted by deleterious environmental events throughout the life span, including gestational and early life insults. This review will address the topic of sex differences in executive function including a discussion of differences arising in response to developmental programming. Work on gender differences in human studies and sex differences in animal research will be reviewed. Overall, we find little support for significant gender or sex differences in executive function. An important variable that factors into the interpretation of potential sex differences include differing developmental trajectories. We conclude by discussing future directions for the field and a brief discussion of biological mechanisms.
Trends and comparative effectiveness of inpatient radical hysterectomy for cervical cancer in the United States (2012–2015)

Objective Report the up-to-date trends in surgical approach for cervical cancer and compare outcomes between open and minimally invasive routes. Methods Radical Hysterectomy (RH) cases from the National Inpatient Sample (NIS) dataset between 2012 and 2015 were grouped into abdominal (ARH) and Minimally Invasive Surgery (MIS). The MIS group was subdivided as "Laparoscopic", "Robotic", and "Converted". Univariate and multivariable logistic regression were used to analyze differences in complication rates. The National Surgical Quality Improvement Dataset 2015 was used for validation. Results A total of 7180 cases from NIS were identified. Overall, there was 44% decline in RH cases from 2012 (n = 2220) to 2015 (n = 1255). A proportionate increase in robotic cases from 31.5% in 2012 to 41.4% in 2015 was noted. By intention to treat analysis, the rate of at least one complication for abdominal cases was 24.8% compared to 10% for MIS (p Conclusions Perioperative complications are significantly lower for MIS procedures. These data should be used for contemporary cost-effective analysis and comprehensive counseling regarding risks and benefits of the surgical approach for cervical cancer.
The Impact of Body Mass Index on Complications After Shoulder Arthroscopy: Should Surgery Eligibility Be Determined by Body Mass Index Cutoffs?

Purpose The goal of this study is to analyze postoperative complications after shoulder arthroscopy stratified by body mass index (BMI) and to quantify the trade-off in postsurgical complications and access to care that occurs with BMI eligibility cutoffs. Methods Patients who underwent shoulder arthroscopy in the National Surgical Quality Improvement Program database from 2015 to 2016 were identified. Patients were categorized on the basis of their BMI. χ2 tests were used to identify differences in complication rates between different BMI categories. Logistic regression was used to calculate the odds ratio of having a major complication by BMI category. The positive predictive value (PPV) was calculated at different BMI cutoffs. Results There were 26,509 shoulder arthroscopy cases identified in the National Surgical Quality Improvement Program database with 383 major complications, for an overall rate of 1.4%. Patients with a BMI >40 had a higher overall complication rate (2.3% vs 1.4%, P = .001), as well as higher rates of readmission (P = .012), pneumonia (P = .030), progressive renal insufficiency (P = .006), and cardiac arrest (P = .008). BMI >40 was associated with an increased risk of major complications (odds ratio, 1.84; confidence interval, 1.29-2.61). A BMI cutoff of 40 would avoid 12% of major complications while excluding 8% of complication-free surgeries. At a BMI cutoff of 40, the PPV was 2.3% where 43 surgeries would be denied for every complication avoided. Conclusion Patients with a BMI >40 have a statistically significant but only slightly increased risk of 30-day complications after shoulder arthroscopy. Instituting a BMI eligibility cutoff at 40 has a low PPV and would prevent 43 complication-free surgeries from proceeding for every complication prevented. Patients should be counseled individually about their risk factors, but denial of shoulder arthroscopy on the basis of BMI alone may not be an appropriate strategy for risk reduction. Level of Evidence Level III, comparative prognostic trial.
Legal Consciousness in Action: Lay People and Accountability in the Jury Room

This paper argues that lay people’s legal consciousness, defined as how they experience and interpret the law and legal meanings, can be studied by observing natural conversation. It proposes a framework that analyzes the contexts when law is invoked to account for social behavior, which enables examination of individuals’ perceptions of law through their utilization of and reactions to it. This framework is applied to recordings of a jury deliberation, an ideal setting due to its institutionally-controlled conditions. The analysis demonstrates that jurors wield law as a conversational resource to create distinctions between legitimate and illegitimate conduct based upon their endogenous understandings of these boundaries. The invocation of law is an important element of the deliberation because it permits jurors to enforce these distinctions and understand their completed duties as aligning with the legal system’s ideals. This paper also discusses the ability of this framework to study the law’s influence in other social institutions, as well as those institutions’ own “consciousness.”
Pediatric Type II Tibial Spine Fractures: Addressing the Treatment Controversy With a Mixed-Effects Model:

Background:Tibial spine fractures, although relatively rare, account for a substantial proportion of pediatric knee injuries with effusions and can have significant complications. Meyers and McKeev...
Batteries Gone Bad

A battery's moment of death may come as a beep, a red warning light, or a complete surprise. If you are lucky (i.e., prepared), you have a power cord or backup battery handy. If you are unlucky (i.e., unprepared), you may find yourself scrambling to resuscitate the device and possibly even the patient.Batteries afford portability and convenience to countless medical devices. The type of battery, single-use or rechargeable, affects device performance and the potential for device failure. Single-use batteries, also known as primary batteries, are the typical AA found in telemetry packs and the button batteries found in hearing aids.1 Types of single-use batteries include alkaline, which are the most common, and lithium, which cost more but provide higher energy output and a longer life for devices such as implantable pacemakers.1, 2 Rechargeable or secondary batteries may recharge when the device is plugged in or require removal and placement in a charger.1 Types of rechargeable batteries include lead-acid, nickel-cadmium (NiCd), nickel-metal hydride (NiMH), and lithium-ion (Li-ion or LIB).1 Lead-acid are the oldest, most inexpensive, and most common secondary battery, typically large in size and found in devices such as wheelchairs.2 NiCd and their less toxic successor, NiMH, provide higher power than lead-acid batteries at a lighter weight, making them practical for such devices as laryngoscopes.1 Li-ion batteries have become increasingly more common, offering the highest energy density and number of recharging cycles for devices such as smartphones and laptops.2Analysts queried the PA-PSRS database for events involving battery failure submitted between January 1, 2018, and December 31, 2018, containing the keywords “battery” and “batteries” in the report narrative or equipment name field. The query identified 363 reports, of which 169 were excluded, leaving 194 reports for further analysis.Four events did reach the patient and resulted in harm or death (i.e., Serious Events). Nearly 98% of the 194 relevant reports did not involve patient harm (i.e., Incidents). Limitations Despite mandatory reporting laws in Pennsylvania, PA-PSRS data is subject to the limitations of self-reporting and the complexity of reporting. The ability to categorize the type of device and battery-related failure is limited by the information provided by the reporter.
Esther and Mordecai : Emergent Team Leadership and Resilience in Crisis

This chapter presents an exegetical analysis of the book of Esther, focusing on the characteristics and actions of Esther and Mordecai as they related to navigating the crisis of possible Jewish genocide in Susa. Using narrative analysis, the exegetical analysis shows evidence of specific characteristics and behaviors that support and exemplify resilience in the characters of Esther and Mordecai. In addition, the analysis establishes the importance of relationship and spirituality in supporting resilience and the emergence of team leadership between Esther and Mordecai. In all, the chapter provides evidence the leaders during the crisis may benefit from team leadership that supports both individual and group resilience.
Missed care relates to nurse job enjoyment and intention to leave in neonatal intensive care

Aim(s) To determine relationships among missed nursing care, job enjoyment and intention to leave for neonatal nurses. Background Being unable to provide required nursing care to infants could contribute to poorer neonatal nurse job outcomes, which may exacerbate staffing challenges. Little evidence exists about how missed nursing care relates to neonatal nurse job outcomes. Method(s) The design was cross-sectional. Secondary data from the 2016 National Database of Nursing Quality Indicators Registered Nurse Survey were used, which included nurse ratings of job enjoyment, intention to leave and missed nursing care. American Hospital Association data from 2016 were used to describe hospitals. Linear and logistic regressions were calculated. Results There were 5,824 neonatal nurses. Mean nurse job enjoyment was 4.26 out of 6 (SD = 0.97). On average, 15% of nurses intended to leave their position. Each one unit increase in missed nursing care was associated with a 0.26 decrease in job enjoyment and a 29% increased odds of intention to leave after controlling for nursing and hospital characteristics. Conclusions Missed nursing care can influence nurse job enjoyment and intention to leave in neonatal care units. Implications for nursing management Neonatal nurse managers should address missed nursing care to improve neonatal nurse job outcomes.
THE PRESENCE OF EXTRACORONARY VASCULAR ABNORMALITIES IS ASSOCIATED WITH SPONTANEOUS CORONARY ARTERY DISSECTION RECURRENCE

Spontaneous coronary artery dissection (SCAD) is an emerging cause of myocardial infarction in younger women. There are known associations between SCAD and extracoronary vascular abnormalities (EVA) such as fibromuscular dysplasia (FMD), aneurysm, pseudoaneurysm, and dissection, but differences in
Public Values and Public Participation: A Case of Collaborative Governance of a Planning Process

Research on public participation in community planning processes often focuses on the design of participation activities and the tensions therein. Past research, however, gives little attention to ...
Queering labels: Expanding identity categories in LGBTQ + research and clinical practice

Current understandings of gender and sexual identities are limited given the diversity of the LGBTQ + community. Researchers and clinicians are constantly challenged by the ever- expanding identity...
Spatial Accessibility Assessment of COVID-19 Patients to Healthcare Facilities: A Case Study of Florida.

During the COVID-19 pandemic, healthcare facilities worldwide have been overwhelmed by the amount of coronavirus patients needed to be served. Similarly, the U.S. also experienced a shortage of healthcare resources, which led to a reduction in the efficiency of the whole healthcare system. In order to evaluate this from a transportation perspective, it is critical to understand the extent to which healthcare facilities with intensive care unit (ICU) beds are available in both urban and rural areas. As such, this study aims to assess the spatial accessibility of COVID-19 patients to healthcare facilities in the State of Florida. For this purpose, two methods were used: the two-step floating catchment area (2SFCA) and the enhanced two-step floating catchment area (E2SFCA). These methods were applied to identify the high and low access areas in the entire state. Furthermore, a metric, namely the Accessibility Ratio Difference (ARD), was developed to evaluate the spatial access difference between the models. Results revealed that many areas in the northwest and southern Florida have lower access compared to other locations. The residents in central Florida (e.g., Tampa and Orlando cities) had the highest level of accessibility given their higher access ratios. We also observed that the 2SFCA method overestimates the accessibility in the areas with a lower number of ICU beds due to the "equal access" assumption of the population within the catchment area. The findings of this study can provide valuable insights and information for state officials and decision makers in the field of public health.
OP0271 JUVENILE LOCALIZED SCLERODERMA: A LARGE RETROSPECTIVE COHORT STUDY FROM A TERTIARY CARE CENTER

Background: Juvenile Localized Scleroderma (jLS) is a rare pediatric inflammatory disease of skin and underlying tissues that may cause significant functional impairment and disfigurement. Management approaches vary and an optimum treatment regimen is lacking. In 2012, a group of jLS researchers of Childhood Arthritis and Rheumatology Research Alliance (CARRA) proposed consensus treatment plans (CTPs), aimed to streamline the approach to care for jLS patients. Objectives: This study aimed to evaluate a large jLS patient cohort seen over a 21-year period in a single tertiary care pediatric hospital in the USA, in order to examine treatments utilized and determine parameters for systemic therapy initiation. Methods: This retrospective cohort study included jLS patients with disease onset in childhood (≤18-years of age) who were seen in rheumatology, dermatology, or combined rheumatology-dermatology clinics from 1999-2020, with ≤ 3 years of follow-up. Data on demographics, disease characteristics, therapies prescribed, and treatment trends were analyzed. Results: Of the 270 jLS patients identified, 101 fulfilled the inclusion criteria. The primary reason for exclusion was The majority of patients who were on systemic immunomodulatory therapy were treated with methotrexate (59/63, 93.6 %) and/or systemic corticosteroids (21/63, 33 %). 5 patients were treated with hydroxychloroquine, 2 of which were also on methotrexate. 6 patients on methotrexate were either switched to or had mycophenolate mofetil added as concomitant therapy. The most common adverse effects observed in methotrexate-treated patients were gastrointestinal complaints (12/61, 19.7%) and fatigue (7/61, 11.5%). The median treatment duration was 50 months (IQR: 33.5). Patients were more likely to receive systemic therapy if they were followed in rheumatology or combined rheumatology-dermatology clinics as compared to dermatology clinics. Finally, 78% of patients with jLS received systemic treatment after 2013 (a year after publication of the CARRA jLS CTP) as compared to 55% of patients prior to 2013 (p Conclusion: This jLS cohort is one of the largest reported from a single center and reflects an increase in the use of systemic therapy since publication of CARRA CTPs in 2012. Further studies on long-term treatment outcomes and therapeutic approaches utilized when first-line treatment failures occur are warranted. References: [1]Li SC, Torok KS, Pope E, et al. Development of consensus treatment plans for juvenile localized scleroderma: a roadmap toward comparative effectiveness studies in juvenile localized scleroderma. Arthritis Care Res (Hoboken). 2012;64(8):1175-1185. Disclosure of Interests: Bugra Egeli: None declared, Johnathan Dallas: None declared, Edwin Anderson: None declared, Michelle Min: None declared, Daniel Mazori: None declared, Stephen Gellis: None declared, Mary Beth Son: None declared, Robert Sundel: None declared, Ruth Vleugels: None declared, Fatma Dedeoglu Consultant of: Novartis
Safe Focused Ultrasound-Mediated Blood-Brain Barrier Opening and Repair is Not Mediated by Tight Junction Degradation

Focused ultrasound (FUS) with microbubbles opens the blood-brain barrier (BBB) to allow targeted drug delivery into the brain; however, the mechanisms of BBB opening and the response of the neurovascular unit at either low acoustic pressures, known to open the BBB transiently, or high pressures that cause brain damage, remain unclear. Employing a transgenic mouse strain where tight junctions (TJs) are labelled with eGFP, we examined TJ strand morphology at 1 and 72 hours post-FUS at both low and high pressures. We find that transient BBB opening due to FUS is not caused by TJ strand damage, unless FUS is used at high pressures, and this is localized primarily in arterioles and capillaries. At high pressures, TJ strands are obliterated and remain unrepaired even at 72 hours, allowing for fibrinogen passage, and persistent microglial activation. Our findings suggest that at low safe pressures, upregulation of transcytosis may likely increase transiently BBB permeability to deliver therapeutics to the brain.
Do I Trust Sending My Kid Back to School

A suburban elementary school experiences an emergency evacuation. This evacuation event reveals trust and safety concerns. Some parents, staff members, and children express safety concerns, and a k...
Asymmetric information and excessive budgets in government bureaucracies

Abstract This paper develops an optimal sequential mechanism for setting the budget of a bureaucracy where the budget setter (the principal) has only partial information concerning the minimum required budget. Bureaucratic slack is constrained by the existence of managers who can replace the current manager but only at a cost due to the need to learn the job. The principal's initial information and the cost of turnover of managers is related to the expected bureaucratic slack. The principal gains information over the budget setting process, so that a previous budget level provides important information for current budget setting.
The control of reactive oxygen species production by SHP-1 in oligodendrocytes

We have previously described reduced myelination and corresponding myelin basic protein (MBP) expression in the central nervous system of Src homology 2 domain-containing protein tyrosine phosphatase 1 (SHP-1) deficient motheaten (me/me) mice compared with normal littermate controls. Deficiency in myelin and MBP expression in both brains and spinal cords of motheaten mice correlated with reduced MBP mRNA expression levels in vivo and in purified oligodendrocytes in vitro. Therefore, SHP-1 activity seems to be a critical regulator of oligodendrocyte gene expression and function. Consistent with this role, this study demonstrates that oligodendrocytes of motheaten mice and SHP-1-depleted N20.1 cells produce higher levels of reactive oxygen species (ROS) and exhibit corresponding markers of increased oxidative stress. In agreement with these findings, we demonstrate that increased production of ROS coincides with ROS-induced signaling pathways known to affect myelin gene expression in oligodendrocytes. Antioxidant treatment of SHP-1-deficient oligodendrocytes reversed the pathological changes in these cells, with increased myelin protein gene expression and decreased expression of nuclear factor (erythroid-2)-related factor 2 (Nrf2) responsive gene, heme oxygenase-1 (HO-1). Furthermore, we demonstrate that SHP-1 is expressed in human white matter oligodendrocytes, and there is a subset of multiple sclerosis subjects that demonstrate a deficiency of SHP-1 in normal-appearing white matter. These studies reveal critical pathways controlled by SHP-1 in oligodendrocytes that relate to susceptibility of SHP-1-deficient mice to both developmental defects in myelination and to inflammatory demyelinating diseases. GLIA 2015;63:1753–1771
Networks of Inextensible Cords

This paper will be concerned with the mechanics of idealized textiles consisting of inextensible filaments. The earliest work this writer has found on the subject is due to Tchebycheff and was published only in brief summary in 1878 under the title “Sur la Coupe des Vetements.” This work apparently consisted of a discussion of certain geometrical properties of such idealized textiles.
Surface-bonded heparin.

The first report of surface-attached heparin was by Gott and co-workers in 1963 [1]. In this work, heparin was attached through formation of a complex with a quaternary ammonium salt which was adsorbed to graphite. The discovery of the thromboresistant properties of heparinized surfaces was inadvertent because the original intent of the work was to evaluate graphite. The graphite surface was treated with a quaternary ammonium salt to sterilize it, and the surface was rinsed in heparin as a simple precautionary measure. Gott’s work showed that the marked thromboresistance of the graphite-benzalkonium-heparin (GBH) surface was due to the presence of heparin attached at the surface. This method held the promise of enabling one to use foreign surfaces in contact with blood without systemic anticoagulation. However, in practice, the GBH coating could not be applied to flexible materials, and thus its use was limited.
Taxation of Domestic Partner Benefits: The Hidden Costs

Many employers provide domestic partner benefits to their employees, especially in the form of health care plans. Domestic partners are not considered spouses under the Internal Revenue Code. Nor, of course, are same-sex spouses so long as DOMA is in effect. Many employers assume that this means all domestic partner (or same-sex spouse) benefits are taxable under the federal tax law. But this is not true. A partner (or same-sex spouse) can qualify as a dependent and benefits paid to dependents are also tax-exempt. A person can qualify as a dependent for purposes of excluding the value of health care plans from income even if the person cannot be claimed as a dependent on the employee taxpayer’s return. This essay describes the applicable rules in some detail. It also provides a survey of colleges and universities that provide such benefits and analyzes how many of such employers are applying the wrong tax law to their employees.
On the use of engine modulation for deceleration control of continuously variable transmission vehicles

The design and evaluation of a control system for a continuously variable transmission (CVT) vehicle is presented in this paper. Studied and simulated are the following three topics: design and evaluation of the control system with a CVT vehicle in acceleration, deceleration and to the sensitivity of the system with respect to changing characteristics of the engine (hot, cold, age). It is shown that the control system proposed here could insure good stability and controllability not only for acceleration of the system but also for deceleration operation, provided that a pulse width modulated (PWM) fuel control scheme for the engine is employed in the system. It seems that the control system designed in this paper is not complicated and does not have large sensitivity with respect to variation of the characteristics of the components of the system and provides the best possible fuel efficiency. In addition, a number of alternate decelerating schemes are presented at the end of the paper for comparison.