cssi/SciSciGPT-SciSciNet huggingface dataset:
Discrete fracture model for coupled flow and geomechanics

We present a fully implicit formulation of coupled flow and geomechanics for fractured three-dimensional subsurface formations. The Reservoir Characterization Model (RCM) consists of a computational grid, in which the fractures are represented explicitly. The Discrete Fracture Model (DFM) has been widely used to model the flow and transport in natural geological porous formations. Here, we extend the DFM approach to model deformation. The flow equations are discretized using a finite-volume method, and the poroelasticity equations are discretized using a Galerkin finite-element approximation. The two discretizations—flow and mechanics—share the same three-dimensional unstructured grid. The mechanical behavior of the fractures is modeled as a contact problem between two computational planes. The set of fully coupled nonlinear equations is solved implicitly. The implementation is validated for two problems with analytical solutions. The methodology is then applied to a shale-gas production scenario where a synthetic reservoir with 100 natural fractures is produced using a hydraulically fractured horizontal well.
Chemical synthesis and optical characterization of regular and magic-sized CdS quantum dot nanocrystals using 1-dodecanethiol

Cadmium sulfide (CdS) quantum dot (QD) nanoparticles have been synthesized using a one-pot noninjection reaction procedure in solvent medium 1-octadecene. This approach used a cadmium salt and 1-dodecanethiol, an organic sulfur, as the cadmium and sulfur sources, respectively, along with a long-chain organic acid (myristic acid, lauric acid, or stearic acid). The acid has dual effects as a surface capping ligand and a solubility controlling agent as well. UV–Vis and photoluminescence (PL) spectrometry techniques were used to characterize the optical properties, along with transmission electron microscopy (TEM) to identify the structure and size. Our newly developed synthesis procedure allowed for investigation of both regular and “magic-sized” CdS QDs by systematically controlling reaction parameters such as reactant type, reactant concentration, and reaction temperature. The organic sulfur (1-dodecanethiol) proved to be a useful sulfur source for synthesizing magic-sized CdS QDs, previously unreported. Several distinctive size regimes of magic-sized quantum dots (MSQDs), including Families 378 and 407, were successfully produced by controlling a small number of factors. The understanding of controlled Cd release in a MSQD formation mechanism is developed.
Changing Social Science to Serve Human Welfare

The long-debated issue whether social scientists should be concerned with improving the human condition, and if so how they should attempt this task, has been raised afresh in the exchange of views between Lee Benson (1978) and Warren Miller (1978) on “Changing Social Science to Change the World.” Before plunging into this debate, however, I should like to suggest that all of us who participate in it are viewing the world from a particular occupational perspective. Some years ago, when George Lundberg’s Can Science Save Us? (1947) was current, a friend suggested to me that a prior question was, “Should science save us?” He may have meant, as Miller suggests, that saving or changing the world is not the principal task of social scientists; or in another meaning, he may have been anticipating more recent critics in noting that a world “saved” by social science might not be one in which everyone would prefer to live. I hope that our efforts will not be counter-productive.
Sex Pheromones and Mating Behavior of Culiseta inornata (Diptera: Culicidae)

Field observations and laboratory experimentation on the mosquito Culiseta inornata (Williston) indicate that a volatile chemical substance (or substances) is involved in the mating behavior of this species. Mating is not dependent on either sound or sight, though these elements of communication may normally be involved. Materials recovered from females stimulate a sexual response in and are attractive to males.
Modified Soave's Art and a Radical Cure the Hischsprung Disease Through the Anus Merely

Objective: To explore the simple method effecting a radical cure of Hischsprung disease through anus modification Soave's art reaches his surgical operation effect under minute circumstances about creating.Methods:Through barium and an enema and rectum mucous membrane biopsy before the trouble art make a definite diagnosis to the Hischsprung disease,and the tooth form last 0.5~1.0cm of thread of method for the rectum incises the rectum and mucous membrane,and the near end was surely along gluing membrane set 8~12 threads towing,leading along that to pull the separation rectum upwaring at the same time to mucous membrane and muscle simple 8~12cm of sheath back downward.It was thus clear that the muscle sheath cover folds turns over out,indicate to achieve the peritoneum returns rolls over more than the standard,cut off the rectum muscle sheath in the this place annular.Indulging going in after central incises the rectum muscle sheath.Leads along the rectum pulling,and was able to show rectum and the second of the ten Heavenly stems form colon tying the membrane blood vessel,then gave the ligation one after another,the through second formnormal intestine tube standard of colon near end 0.5cm is cut off the second form colon outside the anus,incites to action the colon wall entirely layer glues the membrane on the thread with the tooth to be disconnected suturing.Results:Excise in average surgical operation of 29.3cm,time of 18~40cm,pathological changes intestine tubes length average 138min,arts of 60~180min's bleeding simple 5~60mL.Did not have after the art neutralization art complication.Follow up a case by regular visits to all troubles row's just 2~8/d,nothing stool incontinence or dirt excrements of 1~3month.Conclusion:Simple through the anus reforming Soave's art to effect a radical cure the Hischsprung disease is one kind of completely new surgical operation route,safety is effective,and it at the same time realizes effecting a radical cure to the huge colon has gained the biggest cosmetology effect,and has reduced back complication of fixed art.
Structure change of self-crimping bi-component filament after dyeing and finishing process and its elasticity

The purpose of this study was to investigate the apparent performance of different self-crimping bi-component filament fabrics during finishing and the elasticity of their end-products. Therefore,three kinds of PTT / PET self-crimping bi-component filaments made by different factories were woven,dyed and finished under the same process conditions and then compared with polyurethane fiber fabric. The weight reduction rate,weft shrinkage,elastic elongation and elastic recovery percentage of the above four kinds of fabrics were obtained. The results indicated that with the increase of DPF,the weight reduction rate decreases but the weft shrinkage increases. The weight reduction rate decreases as the fabric count increases. The elastic recovery decreases as the elastic elongation increases. Optical microscopy,scanning electron microscopy and differential scanning calorimetry( DSC) examinations showed that due to the finer DPF and larger specific surface area,one kind of PTT / PET filament exhibited separation of the two components resulting from caustic corrosion during the process of dyeing and finishing and hence the high elasticity inherent in bi-component filaments was lost.
Internal Overvoltage Simulation for 500 kV Wu-Cha Double-circuit Transmission Line on Same Tower in Power Transmission and Transformation Project Based on PSCAD

To meet the needs of the 500 k V system debugging Wu-Cha power transmission and transformation project, in this paper, using the electromagnetic transient simulation software PSCAD,calculates and analyzes the power frequency overvoltage, the control voltage, secondary arc current and recovery voltage during the system startup process in 500 k V Wu-Cha power transmission and transformation project, under three modes: the system debugging mode, normal operation mode and maintenance mode, provides theoretical basis for engineering implementation and reference for operation.
Tomato phyE Is Required for Shade Avoidance in the Absence of phyB1 and phyB2.

The phytochrome (phy) family of red and far-red photoreceptors provides plants with critical information about their surrounding environment and can signal downstream developmental and physiological changes. Neighboring plants compete for limited light resources, and their presence is detected by the phytochrome photoreceptors as a reduced ratio of red: far-red light. One common response to shade is increased elongation of petioles and internodes to compete with their neighbors. While the phytochrome family, phyB in particular, has been well studied in Arabidopsis, information about the other phytochrome family members is limited, especially in sympodial crop plants such as tomato, that have a very different architecture from that of the model plant. To study the tomato phytochrome family we took advantage of several existing mutants and generated an artificial miRNA (amiRNA) line to target SlPHYE, the remaining phytochrome B subfamily member with no currently available mutant line. Here, we characterize internode elongation and shade avoidance phenotypes of the SlPHYE amiRNA line (PHYE amiRNA) In addition, higher order phytochrome subfamily B mutants were generated with the PHYE amiRNA line to investigate the role of SlphyE within the phyB subfamily. We find that the PHYE amiRNA line has no detectable phenotype on its own, however in higher order combinations with SlphyB1 and/or SlphyB2 there are notable defects in shade avoidance. Most notably, we find that the triple mutant combination of SlPHYE amiRNA, SlphyB1, and SlphyB2 has a phenotype that is much stronger than the SlphyB1 SlphyB2 double, showing constitutive shade avoidance and little to no response to shade. This indicates that SlphyE is required for the shade avoidance response in the absence of SlphyB1 and SlphyB2.
Finding My Way

In this self-study, the author explores how she experiences isolation and belonging in new situations by walking and taking photographs of shadows along her commute route, the five-mile length of High Street that runs from the San Francisco Bay to the base of the Oakland Hills.
The Study of Political Unrest and Violence: The Middle East

The late Hannah Arendt once observed that “violence itself is incapable of speech, and not merely that speech is helpless when confronted with violence. Because of this speech-lessness political theory has little to say about the phenomenon of violence and must leave its discussion to the technicians;” (Arendt, 1963, p.9). This may have been true at the time of Arendt’s writing. The situation, however, dramatically changed when the violence of the sixties began in earnest. The academic market was soon lost in a maze of articles, books, and analyses of political violence from the perspective of not only political theory but practically every discipline in the social sciences and humanities. These new works supplemented the traditional and earlier studies of violence by the Marxist school and others. Thus by the turn of the decade, the student of political violence was faced with the difficult task of trying to evaluate and sift his way through an ever-expanding plethora of concepts, theories, definitions, explanations, and models of political violence which abounded in the field.
Marrow Stromal Cell (MSC) Growth from Long Term Cryopreserved Bone Marrow.

Author(s): Lane, Thomas A; Garls, Davina; Mackintosh, Ellen; Cramer, Steven C | Abstract: Abstract Autologous MSC are under active investigation for a variety of potential clinical indications in regenerative medicine and gene therapy. The potential to derive autologous MSC from long-term cryopreserved bone marrow has not been fully elucidated. We report here the growth characteristics of MSC from bone marrow that was cryopreserved for more than 10 years. Methods: We identified 3 deceased patients whose cryopreserved autologous bone marrow that was originally intended for autologous transplant, was to be discarded after fulfilling all accepted criteria for discard. The pts were age 46, 47, and 60 at the time of harvest, one had high risk and 2 had metastatic breast cancer (both to bone) and all had had multiple chemotherapy regimens prior to harvest. The marrow was cryopreserved between 1994–1995 in 10% DMSO using a controlled-rate freezer and stored in the vapor phase of liquid nitrogen until June, 2006 (11–12 years). The marrow was thawed in a 37 C waterbath, diluted with an equal volume of PBS, washed × 3 in PBS, resuspended in culture medium with 20% fetal bovine serum and plated at 5 × 10E6 mononuclear cells (mnc)/cm2 in 2 – 4 T175 flasks. Culture medium was changed in 48 hours and the plates were observed during subsequent culture medium changes every 3–4 days. Results: At 2 – 4 days only scattered round cells were observed, but all samples grew scattered spindle-shaped cells were between days 4 – 12. Six of 8 primary cultures became g 70% confluent between days 11 and 21; 2 remained at l 40% confluence until replated (then achieving g 70% confluence at day 31). First passage cultures (n=12) became g 70% confluent in 4 – 10 days (median = 7) and 2nd passage cultures were g 70% confluent in 7 – 10 days (median = 9). Second or 3rd passage cultures yielded 2.1 – 4.2 × 10E6 MSC/T175 (n= 14; median 3.15) and were 89 – 96 % viable. Flow cytometry (n = 3) confirmed that 3rd passage cells stained positive for CD105 and CD73 and negative for CD14 and CD45. Additional characterization of the differentiation potential of these presumptive MSC are in progress. Conclusion: These studies indicate that cells typical for MSC can be readily grown from marrow that has been cryopreserved for g 10 years and suggest that even long-term stored bone marrow may serve as a source of cells for regenerative medicine.
Skin as a Portal of Entry for Systemic Effect: Xenobiotic Metabolism

The body possesses three major portals of entry for environmental agents and these include the skin, the gastrointestinal tract and the respiratory tree. In the past, most pharmaceutical research focused on the oral or parenteral administration of drugs since it was believed that the skin was practically impermeable to such agents. In fact, virtually all drugs applied to the skin were, until recent years, designed only to treat dermatologic diseases involving this tissue and not for systemic effects. However, in recent years, there has been renewed interest in considering the skin as a potential portal of entry for pharmacologic agents. The concept of transdermal drug delivery involves the development of self-contained discrete dosage forms which, when applied to intact skin, deliver the drug(s) through the skin at a controlled rate to the systemic circulation. (Monkhouse and Huq, 1988) The devices currently employed for this approach usually consist of an outer impermeable barrier covering, beneath which is a reservoir of drug with a rate-controlling membrane, contact adhesive and a protective wrapper that is removed prior to application to the skin.
VizSpace: Interaction in the positive parallax screen plane

The VizSpace is a physically situated interactive system that combines touch and hand interactions behind the screen to create the effect that users are reaching inside and interacting in a 3D virtual workspace. It extends the conventional touch table interface with hand tracking and 3D visualization to enable interaction in the positive parallax plane, where the binocular focus falls behind the screen so as not to occlude projected images. This paper covers the system design, human factors and ergonomics considerations for an interactive and immersive gesture-based visualization system. Results are presented from a preliminary user study that validates the usability of VizSpace.
Aerosol generation in compressive concrete fragmentation

Abstract In this study, the macro-, micro-, and nano- scale fragmentation of concrete was studied as a function of different admixtures and inclusions. Fragments were generated by rapidly loading concrete test specimens under 1D axial compression at a constant strain rate and sampling the generated airborne dust during the impact event. The results of this study showed that the aerosol fragment size distributions generated by rapid fragmentation of concrete follow a bi-modal distribution tied to microstructural features of the concrete mix. This experimental behavior is well described by introducing additional length scales in Gilvarry’s derivation of the Rosin-Rammler-Sperlin-Bennet (RRSB) size distribution. On this basis, it is proposed that no new fragmentation theory is needed to describe aerosol particles if concrete fragmentation is regarded as a composite material explicitly considering microstructural features which create stress concentrations on the microscale. By identifying a direct link between microstructural features and aerosol distributions, it will be possible to design concrete microstructures to limit aerosol exposure during dynamic failures such as structural collapse.
Genotype-Specific Measles Transmissibility: A Branching Process Analysis.

Background Substantial heterogeneity in measles outbreak sizes may be due to genotype-specific transmissibility. Using a branching process analysis, we characterize differences in measles transmission by estimating the association between genotype and the reproduction number R among postelimination California measles cases during 2000-2015 (400 cases, 165 outbreaks). Methods Assuming a negative binomial secondary case distribution, we fit a branching process model to the distribution of outbreak sizes using maximum likelihood and estimated the reproduction number R for a multigenotype model. Results Genotype B3 is found to be significantly more transmissible than other genotypes (P = .01) with an R of 0.64 (95% confidence interval [CI], .48-.71), while the R for all other genotypes combined is 0.43 (95% CI, .28-.54). This result is robust to excluding the 2014-2015 outbreak linked to Disneyland theme parks (referred to as "outbreak A" for conciseness and clarity) (P = .04) and modeling genotype as a random effect (P = .004 including outbreak A and P = .02 excluding outbreak A). This result was not accounted for by season of introduction, age of index case, or vaccination of the index case. The R for outbreaks with a school-aged index case is 0.69 (95% CI, .52-.78), while the R for outbreaks with a non-school-aged index case is 0.28 (95% CI, .19-.35), but this cannot account for differences between genotypes. Conclusions Variability in measles transmissibility may have important implications for measles control; the vaccination threshold required for elimination may not be the same for all genotypes or age groups.
United States Medical Licensing Examination

The United States Medical Licensing Examination (USMLE) is a three-step examination that all physicians must complete in order to obtain medical licensure in the United States. The first two steps, Step 1 and Step 2 Clinical Skills (CS) and Clinical Knowledge (CK), are typically taken by US medical students during medical school. For international students or graduates, to be eligible you must be officially enrolled in, or a graduate of, a medical school listed in the World Directory of Medical Schools as meeting Educational Commission for Foreign Medical Graduates (ECFMG) eligibility requirements. In order to be eligible to take Step 3, one must have taken and passed Step 1 and Step 2 CS and CK, in addition to obtaining an MD degree (or its equivalent) or the DO degree from an accredited medical school. This chapter will discuss the first two steps of the USMLE and how to prepare to succeed on test day.
Odds are the sign is right

This article introduces a new condition based on odds ratios for sensitivity analysis. The analysis involves the average effect of a treatment or exposure on a response or outcome with estimates adjusted for and conditional on a single, unmeasured, dichotomous covariate. Results of statistical simulations are displayed to show that the odds ratio condition is as reliable as other commonly used conditions for sensitivity analysis. Other conditions utilize quantities reflective of a mediating covariate. The odds ratio condition can be applied when the covariate is a confounding variable. As an example application we use the odds ratio condition to analyze and interpret a positive association observed between Zika virus infection and birth defects.
Comparing Wayfair to Wynne : Lessons for the Future of the Dormant Commerce Clause

A comparison of South Dakota v. Wayfair with Comptroller of the Treasury of Maryland v. Wynne indicates that the prospect ofthe Supreme Court jettisoning the dormant Commerce Clause altogether is unlikely. However, the justices who would abandon the dormant Commerce Clause can exercise decisive influence in particular cases as they did in Wayfair. The current Court’s dormant Commerce Clause skeptics – Justices Thomas and Gorsuch –provided the crucial fourth and fifth votes in Wayfair to overturn Quill. It will continue to be rare for the Court to reverse its own dormant Commerce Clause decisions. Far from opening the floodgates, Wayfair indicates that the Court is reluctant to overrule its dormant Commerce Clause cases in light of Congress’s ultimate constitutional power to regulate interstate commerce. However,when neither the Court nor Congress has spoken on a particular issue, the Court will consider extending the dormant Commerce Clause as it did in Wynne. Going forward, an important issue under the dormant Commerce Clause will be the double taxation which results when an individual is deemed to be a resident for tax purposes by two states, each of which taxes all of the dual resident’s income. Wayfair and Wynne suggest that, despite the compelling arguments against the double state taxation of dual residents’ incomes, the Court will be reluctant to set aside its precedents upholding the double state taxation of dual residents. The Court is more likely to extend dormant Commerce Clause protection when states are overly-aggressive in taxing the incomes of nonresidents. In particular, the Court is more likely to apply the dormant Commerce Clause apportionment principle to curb New York’s “convenience of the employer” doctrine to avoid New York’s double state income taxation of telecommuters on the days they work at their out-of-state homes.
Blockchains and Databases: A New Era in Distributed Computing

In this tutorial, I survey some of the private blockchain systems with respect to their architectures in general and their approaches to some specific technical areas. Specifically, I focus on how the functionality of traditional and modern data stores are being utilized or not utilized in the different blockchain systems.
The development of a lifetime care model in comprehensive spina bifida care.

PURPOSE To describe the development and implementation of the Children's of Alabama (COA) Spina Bifida (SB) Lifetime-Care-Model, including standardized care protocols and transition plan. METHODS In 2010, members of the pediatric team at COA began to evaluate limitations in access to care for patients with SB at various stages of life. Through clinic surveys, observations, and caregiver report, a Lifetime-Care-Model was developed and implemented. Partnerships were made with adult medicine colleagues to create an interdisciplinary model at each stage. Since developing this program, it has evolved to include standardized care protocols. RESULTS Since 2011, there have been 42 prenatal clinics; 114 families received counseling and prenatal care. Of these, 106 have delivered at our center and established care in our pediatric clinic. There are currently 474 patients in the pediatric and 218 in the adult clinics. CONCLUSIONS Our institutional experience suggests that patients with SB benefit from continuity of care throughout their lifetime. This article describes early failures which led to an evolution in approach and implementation of a Lifetime-Care-Model which results in a smooth transition between all phases of life. We hope that other institutions may adapt and build upon it to create programs unique to their specific patient needs.
The Myth of Bureaucratic Neutrality: Institutionalized Inequity in Local Government Hiring:

As a field, we often relate merit and neutrality to the technical skills needed to be the “best” candidate for a job, but that was not necessarily what civil service reformers had in mind. The civi...
Science at the Hard X-ray Diffraction Limit (XDL2011), Part 1

There is growing excitement in the synchrotron materials science community about the potential of nearly diffraction-limited, high-repetition rate, hard X-ray sources, such as an Energy Recovery Linac (ERL) or an Ultimate Storage Ring (USR), and that these sources will pave the way to scientific insights and discoveries not possible with existing facilities. These future sources will deliver highly coherent, nearly diffraction-limited X-ray beams that will power ultra-intense, nanometer-scale X-ray probes and imaging capabilities approaching atomic resolution. They will produce X-ray pulses at MHz to GHz repetition rates and span pulse durations from below 50 femtoseconds to tens of picoseconds, enabling new classes of experiments in hard X-ray science.
Memory effect of transmission eigenchannels in random media

We have experimentally and numerically studied the angular memory effect of transmission eigenchannels in random media. High-transmission channels have a larger range of memory effect than any input wavefront, thus are robust against sample tilt. © 2019 The Author(s)
Utilizing the TrueBeam Advanced Imaging Package to monitor intrafraction motion with periodic kV imaging and automatic marker detection during VMAT prostate treatments

Background Fiducial markers are frequently used before treatment for image-guided patient setup in radiation therapy (RT), but can also be used during treatment for image-guided intrafraction motion detection. This report describes our implementation of automatic marker detection with periodic kV imaging (TrueBeam v2.5) to monitor and correct intrafraction motion during prostate RT. Methods We evaluated the reproducibility and accuracy of software fiducial detection using a phantom with 3 implanted fiducial markers. Clinical implementation for patients with intraprostatic fiducials receiving volumetric modulated arc therapy (VMAT) utilized periodic on-board kV imaging with 10 s intervals during treatment delivery. For each image, the software automatically identified fiducial locations and determined whether their distance relative to planned locations were within a 3 mm tolerance. Motion was corrected if either ≥2 fiducials in a single image or ≥1 fiducial in sequential images were out of tolerance. Results Phantom studies demonstrated poorer performance of linear fiducials compared to collapsible fiducials, and wide variability to accurately detect fiducials across eight software settings. For any given setting, results were relatively reproducible and precise to ~0.5 mm. Across 17 patients treated with a median of 20 fractions, the software recommended a shift in 44% of fractions, and a shift was actually implemented after visual confirmation of movement greater than the 3 mm threshold in 20% of fractions. Adjustment of our approach led to improved accuracy for the latter (n = 7) patient subset. On average, table repositioning added 3.0 ± 0.3 min to patient time on table. Periodic kV imaging increased skin dose by an estimated 1 cGy per treatment arc. Conclusions Periodic kV imaging with automatic detection of motion during VMAT prostate treatments is commercially available, and can be successfully implemented to mitigate effects of intrafraction motion with careful attention to software settings.
Estimation of Focused Helium Ion Beam Josephson Junction Width

Josephson junctions fabricated with a focused helium ion beam exhibit electrical properties that are strongly dependent on the size of the junction. The length of the junction, in the direction of the super-current, is one of the critical parameters. In this report, we compare three methods of estimating this critical feature, utilizing resistive and capacitive transport data and Monte Carlo ion implantation simulations. Our results find that the barrier is 3 ± 1 nm long and agree well with one another.
Evaluation of Partial Oral Antibiotic Treatment for Persons Who Inject Drugs and Are Hospitalized With Invasive Infections.

Background Persons who inject drugs (PWID) are at risk for invasive infections; however, hospitalizations to treat these infections are frequently complicated by against medical advice (AMA) discharges. This study compared outcomes among 1) PWID who completed a full course of inpatient intravenous (IV) antibiotics, 2) PWID who received a partial course of IV antibiotics but were not prescribed any antibiotics on AMA discharge, and 3) PWID who received a partial course of IV antibiotics and were prescribed oral antibiotics on AMA discharge. Methods Retrospective, cohort study of PWID aged 18 years or older admitted to a tertiary referral center between 01/2016 and 07/2019, who received an Infectious Diseases consultation for an invasive bacterial or fungal infection. Results 293 PWID were included in the study. 90-day all cause readmission rates were highest among PWID who did not receive oral antibiotic therapy on AMA discharge (n=46, 68.7%), compared with inpatient IV (n=43, 31.5%) and partial oral antibiotics (n=27, 32.5%). In a multivariate analysis, 90-day readmission risk was higher among PWID who did not receive oral antibiotic therapy on AMA discharge [adjusted hazard ratio (aHR)=2.32; 95% confidence interval (CI) 1.41 - 3.82] and not different among PWID prescribed oral antibiotic therapy on AMA discharge (aHR=0.99; 95% CI 0.62-1.62). Surgical source control (aHR=0.57; 95% CI 0.37 - 0.87) and addiction medicine consultation (aHR=0.57; 95% CI 0.38 - 0.86) were both associated with reduced readmissions. Conclusions Our single center study suggests access to oral antibiotic therapy for PWID who cannot complete prolonged inpatient IV antibiotic courses is beneficial.
334-OR: Project ECHO T1D Tackles Complexity of Diabetes Cases in Primary Care

Primary care providers (PCPs) manage type 1 diabetes (T1D) and complex diabetes for people who lack access to multispecialty care. Project ECHOTM (Extension for Community Healthcare Outcomes) is a low-dose, high frequency workforce development hub-spoke model that leverages telehealth to connect multidisciplinary specialists (“hub”) with PCPs across regional clinic sites (“spokes”). Applying the ECHO model, we piloted the model for T1D (Project ECHO T1D) in the states of California (CA) and Florida (FL) targeting PCPs managing adult and pediatric patients with T1D. Weekly hour-long teleECHOTM sessions were led by each hub in CA and FL over a 6 month pilot period. Each session included 1 to 2 case presentation. Prior to each teleECHO session, PCPs uploaded de-identified case presentations for discussion via REDCap®. Recommendations were provided by other participants and the multidisciplinary hub teams. Characteristics of case presentations were tracked in CA and FL. During the 6 month intervention, 47 new and follow-up cases were presented in CA and 45 in FL. Middle age adults (33.9±17.4 years-old, 20% pediatric) with poorly controlled diabetes (HbA1c 9.6±2.2% in CA and 10.4±2.8% in FL) were frequent cases. Common thematic questions submitted by PCPs in CA and FL, respectively, included: insulin dose adjustments (49%, 47%), social concerns (37%, 47%), behavioral health (29%, 34%), diabetes devices (44%, 13%), and diabetes education (15%, 38%). Patients commonly had depression (29.3%, 28.1%), recent hospitalizations (27%, 17%) and ER visits (33%, 26%) in the past year. Greatest barriers to care were social support (34%, 28%), financial (29%, 22%), diabetes knowledge (22%, 25%), attitudes and beliefs (27%, 16%) and psychiatric issues (20%, 19%). Findings illustrate the complexity of diabetes being managed by PCPs and the need for healthcare delivery innovation in diabetes education to support PCPs and primary care clinics who manage patients with complex diabetes who lack access to diabetes specialty care. Disclosure N. Cuttriss: None. C. Anez-Zabala: None. L.G. Baer: None. S.L. Filipp: None. M. Basina: None. M.J. Gurka: None. L. Figg: None. M.J. Haller: Advisory Panel; Self; SAB Biotherapeutics, Inc. K.K. Hood: Research Support; Self; Dexcom, Inc. Speaker’s Bureau; Self; LifeScan, Inc., MedIQ. X. Roque: None. R. Lal: Consultant; Self; Abbott, Biolinq. S.C. Westen: None. D.M. Maahs: Advisory Panel; Self; Eli Lilly and Company, Insulet Corporation, Medtronic, Novo Nordisk A/S. Consultant; Self; Abbott, Sanofi. Research Support; Self; Bigfoot Biomedical, Dexcom, Inc., Roche Diabetes Care, Tandem Diabetes Care. M. Town: Other Relationship; Self; Insulet Corporation. C. Wang: None. J.J. Wong: None. K. Yabut: None. A.F. Walker: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust
Degradation of lymphatic anatomy and function in early venous insufficiency.

Abstract Objective We used near-infrared fluorescence lymphatic imaging in a pilot study to assess the lymphatics in preulcerative (C2-C4) venous insufficiency and determine whether involvement and/or degradation of lymphatic anatomy or function could play a role in the progression of chronic venous insufficiency. We also explored the role of lymphatics in early peripheral arterial disease. Methods After informed consent and intradermal injections of indocyanine green for rapid lymphatic uptake, near-infrared fluorescence lymphatic imaging was used to assess the lymphatic anatomic structure and quantify the lymphatic propulsion rates in subjects with early venous insufficiency. The anatomic observations included interstitial backflow, characterized by the abnormal spreading of indocyanine green from the injection site primarily into the surrounding interstitial tissues; dermal backflow, characterized by the retrograde movement of dye-laden lymph from collecting lymphatics into the lymphatic capillaries; and lymphatic vessel segmentation and dilation. Results Ten subjects with venous insufficiency were enrolled, resulting in two legs with C2 disease, nine legs with C3 disease, eight legs with C4 disease, and one leg with C5 disease. Interstitial and/or dermal backflow were observed in 25%, 33%, and 41% of the injection sites in each limb with C2, C3, and C4 disease, respectively. Distinct vessel segmentation and dilation were observed in limbs with a C3 and higher classification, and dermal backflow proximal to the injection sites was observed in two legs with C4 disease and in the inguinal region of the C5 study subject. The overall average lymph propulsion rates were 1.3 ± 0.4, 1.2 ± 0.7, and 0.8 ± 0.5 contractile events/min for limbs with C2, C3, and C4 disease, respectively. One subject with peripheral arterial disease, who had previously undergone bypass surgery, presented with extensive dermal backflow and lymphatic reflux. Conclusions Near-infrared fluorescence lymphatic imaging demonstrated that, compared with normal health subjects, the lymphatic anatomy and contractile function generally degrade with the severity of venous insufficiency. Lymphatic abnormalities mimic those in early cancer-acquired lymphedema subjects, as previously observed by us and others. Additional studies are needed to decipher the relationship, including any causality, between lymphatic dysfunction and peripheral vascular disease and venous insufficiency.
Performativity and Caring in Education: Toward an Ethic of Reimagination:

Schools are expected to be sites of caring, but there is evidence that both students and adults often experience them as uncaring places. One reason is that a sustained and heavy policy emphasis on...
Analysis of Skeletal Muscles Contractility Using Smart SEMG-Based Socks

Surface electromyography increasingly plays an important role for prevention, diagnosis and rehabilitation in healthcare field. In this context, the continuous monitoring of the electrical potentials produced by muscles appears to be effective to detect abnormal events. The recent progresses in surface electromyography technologies have allowed for the development of low invasive and reliable wearable devices. These devices promote long-term monitoring; however, they are often very expensive and not easy to be positioned appropriately. Moreover, they use disposable pre-gelled electrodes that can cause skin redness. In this work, to overcome these issues, a prototype of new smart socks has been realized, implementing reusable and high biocompatible hybrid polymer electrolytes. These electrodes provide a comfortable lower limb long-term monitoring avoiding a difficult daily repositioning by users. The realized socks are lightweight and integrates all electronic components for the pre-elaboration and the wireless data sending. The Gastrocnemius-Tibialis muscles were selected and analyzed due to their relevance for assessment of age-related changes in gait, sarcopenia pathology, postural anomalies, fall risk, etc. In particular, in this paper an evaluation on the risk of falling detection by the system was considered as a case of study.
The potential of eye tracking for visual literacy research

The multitude of disciplines, perspectives, and practices that inform the study of visual literacy is incredibly valuable, but at the same time it means our research lacks a shared set of methodolo...
The Road Most Rewarded

We all face critical decision-making stages in life. What major should I study? Who should I marry? What career should I pursue? Should I quit my job and launch a startup?
Intensity Mapping without Cosmic Variance

Current and future generations of intensity mapping surveys promise dramatic improvements in our understanding of galaxy evolution and large-scale structure. An intensity map provides a census of the cumulative emission from all galaxies in a given region and redshift, including faint objects that are undetectable individually. Furthermore, cross-correlations between line intensity maps and galaxy redshift surveys are sensitive to the line intensity and clustering bias without the limitation of cosmic variance. Using the Fisher information matrix, we derive simple expressions describing sensitivities to the intensity and bias obtainable for cross-correlation surveys, focusing on cosmic variance evasion. Based on these expressions, we conclude that the optimal sensitivity is obtained by matching the survey depth, defined by the ratio of the clustering power spectrum to noise in a given mode, between the two surveys. We find that midinfrared to far-infrared space telescopes could benefit from this technique by cross-correlating with coming galaxy redshift surveys such as those planned for the Nancy Grace Roman Space Telescope, allowing for sensitivities beyond the cosmic variance limit. Our techniques can therefore be applied to survey design and requirements development to maximize the sensitivities of future intensity mapping experiments to tracers of galaxy evolution and large-scale structure cosmology.
Banking on Women Leaders: A Case for More?

Using a new dataset, we measure the large gap between the representation of men and women in leadership positions in banks and bank supervision agencies worldwide. Women occupied less than 2 percent of bank CEOs positions, and less than 20 percent of the board seats in more than 80 percent of the observations across banks over time. Contrary to common perceptions, many low- and middle-income countries have a higher share of women in bank boards and banking supervision agency boards compared to advanced economies. Econometric analysis suggests that, controlling for relevant bank and country-specific factors, the presence of women as well as a higher share of women on bank boards is associated with greater bank stability, as represented by higher z-scores and lower nonperforming loan ratios. We also examine the share of women on boards of banking supervision agencies by compiling a new dataset. We find that it is associated with greater bank stability. Further research is needed to identify specific mechanisms through which these stability benefits are achieved, and to understand the conditions that have facilitated entry of women into leadership roles in banks and supervision agencies.
Donuts and Distant CATEs: Derivative Bounds for RD Extrapolation

Regression Discontinuity (RD) uses policy thresholds to identify causal treatment effects at the threshold. In most settings, the Local Average Treatment Effect (LATE) at the threshold is not the parameter of interest. I provide high level smoothness conditions under which extrapolation across the threshold is possible. Under these restrictions, both estimation and inference for the LATE in other locations is possible. In some situations, extrapolation may be necessary to merely estimate the LATE at the threshold. RD donuts are one such situation, and I provide results allowing estimation and inference in that setting as well.
Adolescent Sex Offenders

Youth-perpetrated violence is a problem of growing concern in today’s society. Data reflect that the incident rate of violent and deadly assaults by juveniles is dramatically higher than at any previous time in American history (Blumstein, 1995). Consistent with the trend of increased violence perpetrated by youths over the past decade, there has been a steady increase in the number of youths arrested for sexual offenses (Snyder & Stickmund, 1995).
Target Abundance-Constrained Mixed Pixel Classification (TACMPC)

The mixed pixel classification (MPC), which was considered in Chapters 8 and 9 is unconstrained with no constraint imposed on the target signature abundance fractions. Consequently, the resulting abundance estimates do not necessarily reflect their true amounts of abundance. In this case, these estimates can be only used for the purpose of target detection, discrimination and classification, but not for target quantification. In order for MPC to perform mixed pixel quantification, we need to consider a fully constrained mixed pixel classification problem, which imposes two constraints on the abundance fractions of target signatures.
The solution conformation of the ferrichromes. V. The hydrogen exchange kinetics of ferrichrome analogues; the conformational state of the peptides.

Abstract The slow amide hydrogen-deuterium exchanges were studied in the ferrichrome analogues gallichrome, alumicrocin, alumichrysin, and alumichrome A at pD 5.14. Substitution of Ga3+ for Al3+ increased the exchange rates, presumably because of a diminished binding affinity of the peptide for the heavier metal ion. An opposite kinetic effect was found upon successive l-seryl-for-glycyl substitutions in the series alumichrome, alumicrocin, and alumichrysin. It is suggested that seryl side chain steric and solvation pressures result in pronounced effects on the peptide backbone conformational stability. Introduction of negative charge, as in alumichrome A, increased the exchange rates, presumably by shifting the parabolic rate-pD curve towards higher pD. ΔH† and ΔS† contributions to the activation free energy were calculated from Eyring plots. The magnitude of the kinetic parameters allows an estimate of the relative contributions of steric shielding and hydrogen bonding to the stability of each slow amide in the different analogues. Since these peptides have essentially identical solution conformations, this study clearly shows that it is insufficient to describe the solution conformation of a peptide without referring, at the same time, to its stability in such a conformation. The concept of conformational state is thus emphasized.
Isolation of anaerobic respiratory mutants of Shewannella putrefaciens and genetic analysis of mutants deficient in anaerobic growth on Fe3

A genetic approach was used to study (dissimilatory) ferric iron (Fe3+) reduction in Shewanella putrefaciens 200. Chemical mutagenesis procedures and two rapid plate assays were developed to facilitate the screening of Fe3+ reduction-deficient mutants. Sixty-two putative Fe3+ reduction-deficient mutants were identified, and each was subsequently tested for its ability to grow anaerobically on various compounds as sole terminal electron acceptors, including Fe3+, nitrate (NO3-), nitrite (NO2-), manganese oxide (Mn4+), sulfite (SO3(2-)), thiosulfate (S2O3(2-)), trimethylamine N-oxide, and fumarate. A broad spectrum of mutants deficient in anaerobic growth on one or more electron acceptors was identified. Nine of the 62 mutants (designated Fer mutants) were deficient only in anaerobic growth on Fe3+ and retained the ability to grow on all other electron acceptors. These results suggest that S. putrefaciens expresses at least one terminal Fe3+ reductase that is distinct from other terminal reductases coupled to anaerobic growth. The nine Fer mutants were conjugally mated with an S. putrefaciens genomic library harbored in Escherichia coli S17-1. Complemented S. putrefaciens transconjugants were identified by the acquired ability to grow anaerobically on Fe3+ as the sole terminal electron acceptor. All recombinant cosmids that conferred the Fer+ phenotype appeared to carry a common internal region.
Achieving high-precision pointing on ExoplanetSat: Initial feasibility analysis

ExoplanetSat is a proposed three-unit CubeSat designed to detect down to Earth-sized exoplanets in an orbit out to the habitable zone of Sun-like stars via the transit method. To achieve the required photometric precision to make these measurements, the target star must remain within the same fraction of a pixel, which is equivalent to controlling the pointing of the satellite to the arcsecond level. The satellite will use a two-stage control system: coarse control will be performed by a set of reaction wheels, desaturated by magnetic torque coils, and fine control will be performed by a piezoelectric translation stage. Since no satellite of this size has previously demonstrated this high level of pointing precision, a simulation has been developed to prove the feasibility of realizing such a system. The current baseline simulation has demonstrated the ability to hold the target star to within 0.05 pixels or 1.8 arcseconds (with an 85 mm lens and 15 μm pixels), in the presence of large reaction wheel disturbances as well as external environmental disturbances. This meets the current requirement of holding the target star to 0.14 pixels or 5.0 arcseconds. Other high-risk aspects of the design have been analyzed such as the effect of changing the guide star centroiding error, changing the CMOS sampling frequency, and reaction wheel selection on the slew performance of the satellite. While these results are promising as an initial feasibility analysis, further model improvements and hardware-in-the-loop tests are currently underway.
Ultrasound in neurolymphomatosis: The rise of the machines

Electrodiagnosis (EMG and nerve conduction studies) has long occupied an enviable position in neurology as the sole technology with which the practitioner could routinely evaluate neuromuscular disease. Its hegemony is now being called into question. For those who like diagnosing patients without the assistance of consultants, ultrasound proves to be the optimal new technique. MRI, a radiology alternative, comes in a distant second. In this issue of Neurology ®, Vijayan et al.1 provide evidence to support the use of neuromuscular ultrasound for the diagnosis of neurolymphomatosis. The article is of particular interest because it highlights the value of color Doppler, one of several useful ultrasound technologies available on current instruments, in nerve imaging.
Nonhemolytic Group B Streptococci of Human, Bovine, and Ichthyic Origin

Abstract The biochemical and serological characteristics of nonhemolytic group B streptococci of human, bovine, and ichthyic origin were described.