cssi/SciSciGPT-SciSciNet huggingface dataset:
Laser Sintering of ZrB2

Preliminary results about laser sintering of zirconium diboride (ZrB2), a good ultra high-temperature ceramics candidate, are presented. In order to evaluate a suitable sintering method, single pulsed laser and a concentric dual laser system were carried out. Two different ZrB2 powders having ∼15 and ∼2 μm particle size were assessed for sintering. Scanning electron microscopy images showed that the concentric dual laser sintered layer using ∼2 μm particle size of ZrB2 had relatively smooth surface morphology. X-ray diffraction results confirmed that the sintered layer mainly retained the crystalline phases as the starting powder. In addition, the rapid cooling rate of laser sintering enabled the formation of needle-like nanostructures at the sintered surface.
Concussion does not impact intraindividual response time variability.

This investigation examined the effect of concussion on intraindividual variability in 5 processing speed tasks. Forty-four adults, including 22 concussed and 22 healthy age- and gender-matched participants, completed the Headminder Concussion Resolution Index (D. M. Erlanger, D. J. Feldman, K. C. Kutner, & M. McCrea, 2001) twice. The test consists of a series of tasks including 25 trials of simple response time task, 70 trials of cued response time task (CuRT), 60 trials each for 2 visual recognition tasks, and 30 trials of symbol scanning task. Concussed participants completed a preinjury baseline assessment and were retested within 48 hours of injury diagnosis. The nonconcussed participants were retested 45 days after initial assessment. Average response time (RT), standard deviation, and response accuracy were calculated for each individual. Overall, concussed individuals had increased RTs across all tasks and were less accurate in the CuRT. RT variability for all tasks was elevated in concussed individuals, but controlling for mean RT at follow-up eliminated group differences. These findings indicate that response-time-variability increases in concussed individuals are proportional to processing-time increases. As such, RT variability is not a unique identifier of cognitive dysfunction following concussion. These results highlight that transient brain injury has significantly different neurobiological
High prevalence of clinically silent severe mitral regurgitation in patients with heart failure: role for echocardiography.

Mitral regurgitation (MR) is common in patients with congestive heart failure (CHF) and has adverse effects on prognosis. In view of the altered hemodynamics in CHF, we examined the accuracy of auscultation for its detection in CHF with reduced systolic function. We examined 370 patients on stable heart failure therapy enrolled in our CHF clinic, if they had a physical examination by one of the two senior cardiologists and an echocardiogram within 2 weeks after the physical examination. The MR murmur was graded 0 to 6 on physical examination. MR was graded 0 to 4 on echocardiography using standard echocardiographic criteria. The left ventricular (LV) ejection fraction was 21 ± 12% and age was 65 ± 15 years. By echocardiography MR was present in 345 patients (94%), being 1+ in 162 (44%), 2+ in 80 (22%), 3+ in 54 (15%), and 4+ in 51 (14%). The frequency of an audible MR murmur by physical examination was 4% in 1+ MR, 11% in 2+ MR, 13% in 3+ MR, and 37% in 4+ MR. The audibility of MR murmur was not related to age, sex, body size, LV size, ejection fraction, or left atrial size. In conclusion, grade 3 or 4+ MR is present in one third of patients with CHF and reduced ejection fraction, and is inaudible in three quarters of them by physical examination. Echocardiography is needed for its detection. Audibility of MR murmur cannot be predicted by body size, LV size, or LV function in these patients.
Isoflavones, Soy-based Infant Formulas, and Relevance to Endocrine Function

For more than 60 years, soy-based infant formulas have been fed to millions of infants worldwide and studied in controlled clinical research. These products provide essential nutrients required for normal growth and development. The safety of isoflavones in soy-based products, including infant formulas, has been questioned recently owing to reports of possible endocrine effects in animals and in cultured cells. The literature offers no evidence of endocrine effects in humans from infant consumption of modern soy-based formulas. Growth is normal and no changes in the timing of puberty or in fertility rates have been reported in humans who consumed soy formulas as infants. Consequently, soy-based infant formulas continue to be a safe, nutritionally complete feeding option for most infants.
Developing high performance asr in the IBM multilingual speech-to-speech translation system

This paper presents our recent development of the real-time speech recognition component in the IBM English/Iraqi Arabic speech-to-speech translation system for the DARPA Transtac project. We describe the details of the acoustic and language modeling that lead to high recognition accuracy and noise robustness and give the performance of the system on the evaluation sets of spontaneous conversational speech. We also introduce the streaming decoding structure and several speedup techniques that achieves best recognition accuracy at about 0.3 x RT recognition speed.
Splitting molecular oxygen en route to a stable molecule containing diphosphorus tetroxide.

In contrast to stable phosphorus oxides such as P4O6 and P4O10 that possess iconic adamantane-like cage structures, highly reactive phosphorus oxides such as PO, PO2, and P2Ox (x = 1–5) only have been studied in the gas phase or by matrix isolation techniques. Elusive diphosphorus tetroxide, the long sought phosphorus analogue of N2O4, is particularly noteworthy. Computations predict that the oxo-bridged O2POPO form of P2O4 is energetically more favored than the P–P bonded O2P–PO2 isomer. Herein, we report the experimental realization of diphosphorus tetroxide—in its energetically disfavored O2P–PO2 form—via carbene-stabilization. The synthesis of the title compound involves the splitting of molecular oxygen by carbene-stabilized diphosphorus.
481 DIFFERENTIAL SENSITIVITY OF HEAD AND NECK SQUAMOUS CELL CANCER CELL LINES TO CISPLATIN-MEDIATED CELL DEATH.

As the fifth most common cancer in the world, head and neck squamous cell carcinoma (HNSCC) continues to have a poor prognosis. One of the standard treatment options is a protocol that uses cisplatin-a platinum-based chemotherapy drug-along with radiation therapy. However, the molecular mechanism of cisplatin-mediated growth arrest is not fully understood. The goals of this study were to (1) compare the cisplatin sensitivity of two different HNSCC cell lines and (2) determine the appropriate conditions for conducting future experiments that decipher cisplatin9s mechanism. The cell-killing effects of cisplatin were studied in vitro on CCL23 (laryngeal squamous cell carcinoma) and CAL27 (tongue squamous cell carcinoma). The cells were treated with cisplatin (6 μg/mL) for durations of 1, 4, 6, and 8 hours and then incubated in media for 0, 24, 48, and 72 hours. In CCL23 cells, there was greater than 50% cell death after 24 hours of incubation for the 4-, 6-, and 8-hour treatment durations. The maximum rate of cell death occurred at a treatment duration of 1 hour and incubation of 24 to 48 hours. In CAL27 cells, none of the treatment durations produced 50% cell death after 24 hours9 incubation. The maximum rate of cell death occurred at a treatment duration of 6 hours and incubation duration of 24 to 48 hours. The data suggest that CCL23 is more sensitive to cisplatin than CAL27. The data also demonstrate the optimal conditions required to achieve measurable cell death in the two cell lines. These conditions are currently being used to conduct experiments that investigate the down-regulation of NF-κB activity through interactions with p16 and p21. We hope that identifying potential biological markers-such as p16-can provide diagnostic tools for cisplatin sensitivity and thus be helpful in the stratification of future patients for cisplatin treatment.
common principle in establishing the limitation

Impurity study and control is one of the key elements for drug safety;it is also an important embodiment of risk management in drug research.Adverse drug reactions always result not only from drug itself but also from its impurities.This paper described the common principles of impurity limitation based on the related content of the guideline of chemical drug impurity study.
Membrane antigen analysis in the diagnosis of lymphoid leukemias and lymphomas. Differential diagnosis, prognosis as related to immunophenotype, and recommendations for testing

The immunophenotypic features of lymphoid leukemias and non-Hodgkin's lymphomas are reviewed. Emphasis is placed on the more recent literature, particularly the insights provided by monoclonal antibodies specific for T and B lymphocytes, and the contributions of flow cytometry. Characteristic immunophenotypes for T- and B-lineage acute lymphoblastic leukemia, the non-Hodgkin's lymphomas, chronic B- and T-cell lymphoproliferative disorders, and multiple myeloma are described. The importance of this information in the diagnostic process and in providing prognostic information concerning disease progression is considered. Limitations associated with monoclonal antibody reagents and flow technology are noted. Representative panels of monoclonal antibodies as used in the author's laboratory for characterizing these disorders are presented and discussed in light of the author's experience.
A SPECTROPHOTOMETRIC METHOD FOR THE DETERMINATION OF CHOLINE DEHYDROGENASE

The increased oxygen uptake of liver suspensions on the addition of acetylcholine, which was reported by Bernheim and Bernheim in 1933 (2), was shown by Mann and Quastel (3) to be due to the oxidation of choline. Betaine aldehyde was identified as the oxidation product (3). The choline oxidase (CO) system was found by Marm, Woodward, and Quastel (4) to consist partly of a typical dehydrogenase. They demonstrated that, in the presence of choline, rat liver extracts reduced sodium ferricyanide anaerobically and cytochrome c aerobically and concluded that the CO system consisted of choline dehydrogenase (CD), cytochrome c, and cytochrome oxidase. During the course of developing the procedure presented in this paper, it was found (1) that the antimycin-sensitive factor of the succinoxidase and diphosphopyridine nucleotide (DPN) cytochrome c reductase systems (5, 6) was involved in the oxidation of choline by rat liver and kidney. This was confirmed by Ebisuzaki and Williams in a subsequent report (7). Evidence was also obtained (1) implicating the Slater factor (8), believed to be a component of the succinoxidase system required for the transmission of electrons between cytochrome b and cytochrome c, in the CO system. Since both BAL and antimycin inhibit CO, and since the inhibition is reversed by artificial carriers such as methylene blue and brilliant cresyl blue,l it is possible that the two compounds are acting on the same substance, although this has yet to be proved. It should be noted, as pointed out by Edelhoch et al. (9), that the lack of effect of antimycin on a soluble DPN cytochrome c reductase (9) may indicate that the arltibiotic acts on some site in particulate preparations which affects reductase activity and not on the reductase protein per se. While no other component of the CO system has been unequivocally identified, riboflavin (10, 11) in the form of flavin-adenine dinucleotide (7), DPN (12-14), folic acid, Leuconostoc citrovorum factor, vitamin B12, and ascorbic acid (15-18) have all been shown t.o enhance the activity of liver CO. A soluble CD
Analysis of difference of primes

While researching mathematical aspects cryptography we created methods on finding primes, with the initial premise of making an efficient algorithm for finding primes. While finding the primes we started to make a set of primes ordered from the set of primes that we already had found. This second order of primes is what we are basing this investigation on. While this was unique, we found more interesting results by comparing the difference of primes of the second order prime set and the initial prime set. We graphed the results of primes up to 400,000,000. We graphed the occurrences of the set of differences.
Sanctifying the Bourgeoisie: The Cultural Work of The Comedy of Errors

The Comedy of Errors is Shakespeare’s most wholehearted evocation and celebration of bourgeois life. The Merry Wives of Windsor might reasonably be seen as a competitor, but that play is not, like Errors, thoroughly committed to the evocation of a commercial and urban context. Closer in time and spirit to Errors, The Taming of the Shrew evokes a bourgeois context, but does not seem especially interested in it, and Shrew, of course, evokes other contexts as well (a very grand aristocratic household in the ‘induction’; a mid-level gentry country household after the wedding). There is no representation whatever of aristocratic life in Errors; the duke in the play is, as we shall see, a figure conceived in terms of juridical rather than social status, and his initial presentation in the play is as participating in (something like) a trade-war. Errors gives us, uniquely, a world of merchants — every one of whom is honest, generous, and admirable. There is not a single lie, deception, crooked or devious business dealing in the play. Contracts are honored, and it is a matter of shame not to do so. Money in the play is neither filthy nor corrupting. No one is self-conscious about it and no one is greedy. It is taken as perfectly normal not to cheat and to expect not be cheated. If there is a play by Shakespeare that shows us people fully and happily at home in an urban, commercial world, it is The Comedy of Errors.
The Civic Discourse of the Neighborhood Associations of Madrid: From Community Improvement to “Citizen Movement”

As this Asociacion de Vecinos’ (AV) declaration makes clear, in many ways the civic discourse of the two types of community-based associations overlapped, in their concern with building horizontal ties and establishing a vertical working relationship with the state in order to achieve their goals of improving the collective quality of life in their towns and neighborhoods.
Thermoluminescence in Polymers Induced by Radiation

Ionizing radiation, as it passes through matter, excites and ionizes the molecules surrounding its trajectory. The secondary electrons which are extracted from the molecules during ionization progressively transfer their kinetic energy to the medium until they become thermic. A thermic electron will be at a distance r t from the ion from which it has been issued (parent ion). Several cases may be cited [1]: 1. If the distance r t is less than a certain critical distance r c to which the Coulomb attraction is exerted by the parent ion (that is, r t <r c ), then the electron will be drawn toward the parent ion, which it will neutralize and form into a highly excited molecule. Such highly excited molecules formed by neutralization eventually become inactive, whether it be by decomposition, internal conversion, collision, or a combination of two or more of these factors. The return to the parent ion is very rapid. The time which elapses between the process of ionization and the process of neutralization can be estimated at less than 10-10 sec. If the neutralization is followed by an emission of light, this emission will occur 10-7-10-8 sec after ionization if the emission takes place beginning with a singlet state and 10-3 sec to several minutes if it is from a triplet state. 2. If r t >r c , the electron breaks free and may recombine not necessarily with its parent ion, but with any of the ions present in the medium. Under normal conditions, the time between ionization and neutralization may be estimated at 10-2-10-3 sec.
The Quality of Outpatient Care Delivered to Adults in the United States, 2002 to 2013

Importance Widespread deficits in the quality of US health care were described over a decade ago. Since then, local, regional, and national efforts have sought to improve quality and patient experience, but there is incomplete information about whether such efforts have been successful. Objective To measure changes in outpatient quality and patient experience in the United States from 2002 to 2013. Design, Setting, and Participants We analyzed temporal trends from 2002 to 2013 using quality measures constructed from the Medical Expenditure Panel Survey (MEPS), a nationally representative annual survey of the US population that collects data from individual respondents as well as respondents’ clinicians, hospitals, pharmacies, and employers. Participants were noninstitutionalized US adults 18 years or older (range, 20 679-26 509 individuals each year). Measures Outpatient quality measures were compiled through a structured review of prior studies and measures endorsed by national organizations. Nine clinical quality composites (5 “underuse” composites, eg, recommended medical treatment; 4 “overuse” composites, eg, avoidance of inappropriate imaging) based on 39 quality measures; an overall patient experience rating; and 2 patient experience composites (physician communication and access) based on 6 measures. Results From 2002 to 2013 (MEPS sample size, 20 679-26 509), 4 clinical quality composites improved: recommended medical treatment (from 36% to 42%; P P P P = .02). Two clinical quality composites worsened: avoidance of inappropriate medical treatments (from 92% to 89%) and avoidance of inappropriate antibiotic use (from 50% to 44%; P P Conclusions and Relevance Despite more than a decade of efforts, the clinical quality of outpatient care delivered to American adults has not consistently improved. Patient experience has improved. Deficits in care continue to pose serious hazards to the health of the American public.
La revisión por pares iguales: un instrumento de innovación educativa

Este articulo trata sobre la revision por pares iguales, su definicion y su utilizacion como un metodo de ensenanza aprendizaje en la practica de la escritura en todas las disciplinas ensenadas a nivel superior. Se senalan las ventajas y desventajas de este proceso y se ofrecen modelos para implementarla y evaluarla en el salon de clase.
A multicenter study evaluating the frequency and time requirement of mechanical thrombectomy.

Introduction There are few published data evaluating the incidence of mechanical thrombectomy among stroke centers or the times at which they occur. Methods A multicenter retrospective study was performed to identify all patients undergoing emergent thrombectomy for acute ischemic stroke during a 3-month period (June through August 2016). Consultations that did not undergo thrombectomy were not included. Results Ten institutions participated in the study. During the 92-day study period, a total of 189 patients underwent mechanical thrombectomy. The average number of procedures per hospital over the study period was 18.9 (average of 0.2 cases per day per or 75.6 cases per year). This ranged from 0.09 cases per day at the lowest volume center to 0.49 cases per day at the highest volume center. Procedures were more common on weekdays (p Conclusions These findings indicate that the majority of mechanical thrombectomy cases occur during non-work hours, with associated off-hours delays, which has important operational implications for hospitals implementing stroke call coverage.
Overtreatment and Deintensification of Diabetic Therapy among Medicare Beneficiaries

Deintensification of diabetic therapy is often clinically appropriate for older adults, because the benefit of aggressive diabetes treatment declines with age, while the risks increase. We examined rates of overtreatment and deintensification of therapy for older adults with diabetes, and whether these rates differed by medical, demographic, and socioeconomic characteristics. We analyzed Medicare claims data from 10 states, linked to outpatient laboratory values to identify patients potentially overtreated for diabetes (HbA1c 9.0%). Of 78,792 Medicare recipients with diabetes, 8560 (10.9%) were potentially overtreated. Overtreatment of diabetes was more common among those who were over 75 years of age and enrolled in Medicaid (p < 0.001), and was less common among Hispanics (p = 0.009). Therapy was deintensified for 14% of overtreated diabetics. Appropriate deintensification of diabetic therapy was more common for patients with six or more chronic conditions, more outpatient visits, or living in urban areas; deintensification was less common for those over age 75. Only 6.9% of Medicare recipients with diabetes were potentially undertreated. Variables associated with overtreatment of diabetes differed from those associated with undertreatment. Medicare recipients are more frequently overtreated than undertreated for diabetes. Medicare recipients who are overtreated for diabetes rarely have their regimens deintensified.
Vancomycin Dosing in Obese Patients: Special Considerations and Novel Dosing Strategies:

Objective: To review the literature regarding vancomycin pharmacokinetics in obese patients and strategies used to improve dosing in this population. Data Sources: PubMed, EMBASE (1974 to November ...
Voiding cystourethrography after prostatectomy: spectrum of appearances.

This article reviews current prostatectomy techniques and then techniques for fluoroscopic voiding cystourethrography (VCUG) evaluation of the prostate and bladder after prostatectomy. Both normal post-prostatectomy appearances and complications will be reviewed. VCUG is a useful evaluation for both common and uncommon post-prostatectomy complications and appropriate interpretation of the VCUG complications is important to aid the urologist’s clinical decision making.
Independent predictors of spinal epidural abscess recurrence.

Abstract Background Context Recurrence of spinal epidural abscess (SEA) after treatment is an important cause of continued morbidity for patients. Purpose The purpose of this study was to identify independent predictors of recurrence of SEA. Study Design/Setting This was a retrospective, case-control study. Patient Sample Patients 18 years or older with a diagnosis of SEA admitted to our hospital system during the study period were included in the study sample. Outcome Measures The outcome measure was recurrence of SEA, defined as a reaccumulation of pus or infected granulation tissue in the epidural space after initial treatment. Methods All patients older than 18 years admitted to our hospital system with a diagnosis of SEA from 1993 to 2016 were identified, and explanatory variables and outcomes were collected retrospectively. Patients 18 years or older diagnosed with SEA were included. We excluded patients whose treatment was initiated at an outside institution. Bivariate and multivariate analyses were performed to identify independent predictors of recurrence. Results We identified 1,053 patients with SEA. We only considered patients to be recurrence-free if they had no documented recurrence with greater than 20 weeks of follow-up. Five hundred thirty-four patients were recurrence-free and 38 had documented recurrence, yielding 572 patients who were included in this analysis. Bivariate and multivariate analyses identified three independent predictors of recurrence: history of intravenous drug use, fecal incontinence or retention, and local spinal wound infection. Conclusions Patients with SEA who have a history of intravenous drug use, bowel dysfunction at presentation, or concurrent local spinal wound infection are at increased risk of disease recurrence. These patients ought to be closely followed up after discharge, with frequent serial imaging and aggressive antibiotic treatment.
Natural mortality augments population fluctuations of forage fish

Forage fish are a vital part of marine ecosystems, partly by supporting some of the largest fisheries worldwide, but also due to their role in food webs as prey for larger fish and other predators. One of the unresolved questions about forage fish dynamics is the causes of their significant temporal fluctuations. These fluctuations are often attributed to changes in environmental conditions, but direct correlations have proven hard to find. Here, we show how time‐varying predation mortality additionally plays a substantial role in forage fish population fluctuations. By analysing 10 stocks that have estimates of natural mortality changes through time, we find that natural mortality on average increases as population biomass declines towards a trough, and to a lesser degree decreases, when their biomass is growing towards a peak. While depensatory mortality was dominant on average in biomass dynamics leading up to peaks or troughs, some of the stocks exhibited compensatory mortality emphasizing variation between stocks. Furthermore, we show that the magnitude of natural mortality and productivity is generally higher than fishing mortality. The results underscore the importance of top‐down control on the dynamics of forage fish. We conclude that a holistic ecosystem analysis is required for a better ecological understanding of forage fish dynamics.
Human papillomavirus prevalence and clinicopathological associations in oropharyngeal squamous cell carcinoma in the Lebanese population.

Objectives To evaluate for the first time the prevalence of human papillomavirus in oropharyngeal squamous cell carcinoma in a Middle-Eastern population, and to determine associations between human papillomavirus profiles and clinicopathological characteristics. Methods A retrospective chart review was conducted of all patients treated for oropharyngeal squamous cell carcinoma at the Hotel Dieu de France University Hospital (Beirut, Lebanon) between January 2010 and 2016. Existing formalin-fixed paraffin-embedded tumour samples were analysed. Human papillomavirus DNA viral load and p16 expression were evaluated using polymerase chain reaction and immunohistochemistry respectively. Results Thirty patients (mean age of 60 years) were included. Twenty-seven per cent of patients were p16-positive/human papillomavirus DNA positive, 53 per cent were p16-negative/human papillomavirus DNA negative and 20 per cent were p16-positive/human papillomavirus DNA negative. Human papillomavirus 16 was the most frequent subtype (75 per cent). Smoking and alcohol consumption were significantly lower in the human papillomavirus positive group compared to the human papillomavirus negative group (p = 0.049 and 0.004, respectively). Conclusion Human papillomavirus rate was lower than reported rates in Western populations. Possible explanations include differences in social and cultural behaviours.
Clinical Applications of Histone Deacetylase Inhibitors

Abstract Aberrations in histone acetyltransferases and histone deacetylases (HDAC) have been associated with tumor development and tumor progression. Pharmacological interference with histone acetylation and methylation has shown to be promising for the treatment and prevention of cancer. Several structurally and functionally different HDAC inhibitors have been developed as a novel modality to reverse aberrant epigenetic changes in cancer cells. With a growing body of literature, there is ample preclinical rationale to test these drugs in various stages and settings of cancer, either as single agents or in rationally designed combinations as a therapeutic strategy in hematological as well as solid tumor malignancies. The first HDAC inhibitor vorinostat (Zolinza) was approved for the treatment of patients with cutaneous T-cell lymphoma. HDAC inhibitors have also demonstrated great promise in treating a variety of noncancer diseases, including epilepsy, cystic fibrosis, spinal muscular atrophy, and human immunodeficiency virus infection.
The Significance of Hereditary Asplenia for Immunologic Competence

Immunologic integrity results from a finely controlled balance of the cellular and molecular mechanisms that provide for surveillance, tolerance, and immunologic response. In recent years, as knowledge of these mechanisms has evolved, the spleen has emerged as an important regulatory organ that exerts myriad influences upon lymphocytes in situ as well as in other immunologic domains. This chapter, in addition to presenting a comprehensive view of splenic immunologic capability, will also focus on the concept that the spleen is influential to the maturation and function of lymphocytes within other immunologic sites (Battisto et al, 1971; Welles and Battisto, 1978, 1979). Both of these objectives will be achieved by examining studies of the hereditarily asplenic mouse, which provides a unique vehicle for the evaluation of splenic influences upon immunologic function.
Sinus Surgical Techniques from Caldwell-Luc to MIST

Surgical treatment for chronic and acute sinus infections, including polyposis, began with external trans-facial approaches requiring skin incisions and their associated issues. The first attempt at concealing external incisions for access to a sinus was the Caldwell-Luc procedure using a sublabial approach. While the incision was not visible, the morbidity of the procedure was as patients always had a swollen cheek and upper lip, ipsilateral anesthesia of V2, and nasal packing.
Fertilizer trials for bareroot nurseries in North America

In North America, most tree nursery nutrition publications during the past two decades involved either container-grown stock or stock grown in greenhouses. In contrast, most bareroot nursery fertility trials in North America were published during the last century. As a result, some bareroot fertilization recommendations have remained the same since 1980 and some practices continue to be based on myths and assumptions. The bareroot nursery industry in the USA might benefit if the next generation of graduate students will consider testing old and new theories about nursery fertilization. Hopefully, they will discover new facts so that future fertilization regimes will be based on science. This paper provides various fertilizer trials that should be established in bareroot nurseries.
Polypentenamer Renaissance: Challenges and Opportunities

This Viewpoint highlights the viability and increasing variety of functionalized polypentenamers as unique and valuable materials created through enthalpy-driven ring-opening metathesis polymerization (ROMP) of low ring strain cyclopentene monomers. The terms “low ring strain” and “enthalpy-driven” are typically conflicting ideologies for successful ROMP; however, these monomers possess a heightened sensitivity to reaction conditions, which may be leveraged in a number of ways to provide performance elastomers with good yield and precise functional topologies. Over the last several years, a rekindled interest in these systems has led to a renaissance of research aimed at improving their synthesis and exploring their potential. Their chemistry, applications, and future outlook are discussed.
Remote microphone systems for preschool-age children who are hard of hearing: access and utilization

Objectives: Children who are hard of hearing (CHH) have restricted access to auditory-linguistic information. Remote-microphone (RM) systems reduce the negative consequences of limited auditory acc...
Comparison of Wait Times for New Patients Between the Private Sector and United States Department of Veterans Affairs Medical Centers.

Importance Concerns have been raised about the adequacy of health care access among patients cared for within the United States Department of Veterans Affairs (VA) health care system. Objectives To determine wait times for new patients receiving care at VA medical centers and compare wait times in the VA medical centers with wait times in the private sector (PS). Design, Setting, and Participants A retrospective, repeated cross-sectional study was conducted of new appointment wait times for primary care, dermatology, cardiology, or orthopedics at VA medical centers in 15 major metropolitan areas in 2014 and 2017. Comparison data from the PS came from a published survey that used a secret shopper survey approach. Secondary analyses evaluated the change in overall and unique patients seen in the entire VA system and patient satisfaction survey measures of care access between 2014 and 2017. Main Outcomes and Measures The outcome of interest was patient wait time. Wait times in the VA were determined directly from patient scheduling. Wait times in the PS were as reported in Merritt Hawkins surveys using the secret shopper method. Results Compared with the PS, overall mean VA wait times for new appointments in 2014 were similar (mean [SD] wait time, 18.7 [7.9] days PS vs 22.5 [7.3] days VA;P = .20). Department of Veterans Affairs wait times in 2014 were similar to those in the PS across specialties and regions. In 2017, overall wait times for new appointments in the VA were shorter than in the PS (mean [SD], 17.7 [5.9] vs 29.8 [16.6] days;P Conclusions and Relevance Although wait times in the VA and PS appeared to be similar in 2014, there have been interval improvements in VA wait times since then, while wait times in the PS appear to be static. These findings suggest that access to care within the VA has improved over time.
Gingival Health of Porcelain Laminate Veneered Teeth: A Retrospective Assessment.

Clinical Relevance Porcelain laminate veneers offer a reliable and successful esthetic treatment, maintaining the long-term gingival health of the surrounding tissues.
Tools for identifying partisan gerrymandering with an application to congressional districting in Pennsylvania

Abstract In League of Women Voters v. Commonwealth of Pennsylvania (2018) the Pennsylvania Supreme Court struck down as a “severe and durable” partisan gerrymander the congressional map drawn by Republicans in 2011 and used in elections from 2012-2016. It did so entirely on state law grounds after a three-judge federal court had rejected issuing a preliminary injunction against the plan. After Pennsylvania failed to enact a lawful remedy plan of its own (due to total disagreement as to how to proceed between the newly elected Democratic governor and the still Republican-controlled legislature), the Court then ordered into place for the 2018 election a map of its own drawn for it by a court-appointed consultant. In a split court, the Court map was endorsed only by judges with Democratic affiliations. Here we compare the 2011 and 2018 congressional maps in terms of a variety of proposed metrics for detecting partisan gerrymandering. We also examine the remedy map proposed by a group of Republican legislators and that proposed by the Democratic governor. We conclude that the 2011 map was a blatant and undisguised pro-Republican gerrymander. Moreover, the remedy map proposed by Republican legislators was a covert pro-Republican gerrymander (what we refer to as a “stealth gerrymander”). The Democratic governor's proposed plan cannot be classified as a pro-Democratic gerrymander and indeed has, if anything, a slight pro-Republican tilt. The 2018 court-drawn remedial map, by all measures, was not a gerrymander.
Boundary-Spanning Actors in Urban 4-H: An Action Research Case Study

Today’s Cooperative Extension organization continues to face challenges of providing relevant, quality programming in urban communities. Challenges include the ability to build capacity in Extension’s urban youth educators to assess and interpret the unique, variable needs of urban clients and to communicate effectively the identified needs to the state land-grant institution to leverage resources. To be responsive, intentional change can be informed and initiated by those closest to the challenges of creating thriving 4-H programs in urban environments – the urban Extension youth educator. Guided by open and sociotechnical systems theory, this multiple case action research study used the critical incident methodology to explore boundary-spanning behaviors of urban Extension youth educators. Four conclusions were drawn from an analysis of the findings including an adaptation of the community-based problem solver quadrant of the Weerts and Sandmann (2010) university–community engagement model. Boundary-spanning behaviors can inform organizational policies related to program development, staff development, hiring procedures, and performance evaluation procedures.
A Dictionary of the History of Medicine. Anton Sebastian. Pearl River, NY: Parthenon Publishing Group Inc., 1999, 784 pp., $98.00. ISBN 1-85070-021-4.

The first book, Dates in Medicine: A Chronological Record of Medical Progress over Three Millennia , is a collection of “important milestones in the development—since antiquity—of modern medicine”. It is a massive listing of approximately 6000 dates for persons and events from 8000 BC to 1999. I was somewhat confused by the frequent use of birth dates rather than the date of the medical progress event, and it would have helped to have had an index. But of greater concern was the absence of dates of important medical progress events over the last 50 years. For example, there are no dates for the introduction of enzyme markers in serum that signal acute myocardial infarction [1954 …
Irisin induces trophoblast differentiation via AMPK activation in the human placenta

Irisin, an adipokine, regulates differentiation and phenotype in various cell types including myocytes, adipocytes, and osteoblasts. Circulating irisin concentration increases throughout human pregnancy. In pregnancy disorders such as preeclampsia and gestational diabetes mellitus, circulating irisin levels are reduced compared to healthy controls. To date, there are no data on the role and molecular function of irisin in the human placenta or its contribution to pathophysiology. Aberrant trophoblast differentiation is involved in the pathophysiology of preeclampsia. The current study aimed to assess the molecular effects of irisin on trophoblast differentiation and function. First-trimester placental explants were cultured and treated with low (10 nM) and high (50 nM) physiological doses of irisin. Treatment with irisin dose-dependently increased both in vitro placental outgrowth (on Matrigel™) and trophoblast cell-cell fusion. Adenosine monophosphate-activated protein kinase (AMPK) signaling, an important regulator of cellular energy homeostasis that is involved in trophoblast differentiation and pathology, was subsequently investigated. Here, irisin exposure induced placental AMPK activation. To determine the effects of irisin on trophoblast differentiation, two trophoblast-like cell lines, HTR-8/SVneo and BeWo, were treated with irisin and/or a specific AMPK inhibitor (Compound C). Irisin-induced AMPK phosphorylation in HTR-8/SVneo cells. Additionally, as part of the differentiation process, integrin switching from α6 to α1 occurred as well as increased invasiveness. Overall, irisin promoted differentiation in villous and extravillous cell-based models via AMPK pathway activation. These findings provide evidence that exposure to irisin promotes differentiation and improves trophoblast functions in the human placenta that are affected in abnormal placentation.
A Co-MOF-derived oxygen-vacancy-rich Co3O4-based composite as a cathode material for hybrid Zn batteries.

Through the integration of Zn-Co3O4 and Zn-air batteries at the cell level, a hybrid battery was assembled, which possessed a higher voltage and power density than a common Zn-air battery. In this hybrid battery, the cathode material is composed of oxygen-vacancy-rich Co3O4−x and N, S-co-doped carbon derived from a metal–organic framework; a Zn plate acts as the anode. With a current of 1 A g−1, the specific capacity of the cathode material achieves 144 mA h g−1. A four-electron process dominates the oxygen reduction reaction of the cathode material with a half wave potential of 0.78 V. In the oxygen evolution reaction, the η10 potential of the cathode material is merely 365 mV. When discharged at 1 mA cm−2, the hybrid Zn battery shows two discharge plateaus at 1.75 V and 1.11 V. Its specific capacity and energy density reach 711 mA h g−1 and 810 W h kg−1, respectively. This battery also inherits superior power density from the Zn-Co3O4 battery. Its peak power density occurs at 43.6 mW cm−2, and this value is obviously higher than that of the Zn-air battery built from the same cathode material. The hybrid battery also exhibits excellent stability with a capacity and charge–discharge voltage that are well maintained after long time periods. This study integrates two distinct batteries into one power source to develop a hybrid Zn battery, which possesses high voltage, specific capacity and superior power and energy densities.
EVALUATION OF THE ACADEMIC RESEARCH CONSORTIUM HIGH BLEEDING RISK DEFINITION IN PATIENTS TREATED WITH DRUG-COATED STENTS AND BARE-METAL STENTS FROM THE LEADERS FREE I & II TRIALS

Consensus-based criteria defining high bleeding risk (HBR) were recently developed by the Academic Research Consortium (ARC) to promote consistency. The objectives are to evaluate if the ARC HBR definitions can accurately identify a higher bleeding risk subset among participants enrolled in the
Damage-mitigating control of space propulsion systems for high performance and extended life

Calculations are presented showing that a substantial improvement in service life of a reusable rocket engine can be achieved by an insignificant reduction in the system dynamic performance. The paper introduces the concept of damage mitigation and formulates a continuous-time model of fatigue damage dynamics. For control of complex mechanical systems, damage prediction and damage mitigation are carried out based on the available sensory and operational information such that the plant can be inexpensively maintained and safely and efficiently steered under diverse operating conditions. The results of simulation experiments are presented for transient operations of a reusable rocket engine.
Tuber luomae, a new spiny-spored truffle species from the Pacific Northwest, USA

Tuber luomae, a new truffle species known only from the Pacific Northwest, USA, is distinguished by spiny, non-reticulate spores and a two-layered peridium - the outermost layer (pellis) consists of inflated, globose to subpolygonal cells and the inner (subpellis) of narrow hyphae. ITS sequence analyses show that it has phylogenetic affinity to other Tuber species in the Rufum clade. The only other members of the Rufum clade with a strongly developed peridiopellis of large, inflated cells are the southern European T. malacodermum and T. pustulatum and the northern Mexican T. theleascum. We find it interesting that this peridial structure that is uncommon in the Rufum clade has been found in geographically disjunct species.
Wave-driven non-classical electron transport in a low temperature magnetically expanding plasma

The presence of instabilities in a low density, low temperature plasma expanding through an axially symmetric magnetic nozzle is investigated in the context of non-classical electron cross field transport. Electrostatic probes are used to characterize the background plasma properties and instabilities. The measurements show a primarily azimuthally propagating mode with a broad, incoherent power spectrum that appears linear at low frequencies. It is demonstrated that the observed dispersion is consistent with the lower hybrid drift instability. The energy and linear growth rate of this wave are related through quasilinear theory to an effective electron collision frequency that is shown to be dominant over classical collisions.
Trends in Nutrient- and Non-Nutrient-Containing Dietary Supplement Use among US Children from 1999 to 2016.

OBJECTIVES To characterize dietary supplement use among US children, including product type, motivations, user characteristics, and trends over time with a primary focus on non-vitamin/non-mineral dietary supplements (NVNM). STUDY DESIGN Overall, NVNM, and vitamin and/or mineral dietary supplement only (VM-only) use; motivations for use; and trends in use over time were examined in children (≤19 years of age) using the National Health and Nutrition Examination Survey 1999-2016 data (n = 42 510). RESULTS Between 1999 and 2016, overall dietary supplement and VM-only dietary supplement use among all children remained relatively stable at ∼30%; yet, NVNM dietary supplement use increased from 2.9% to 6.4%, mainly due to increased use of omega-3 polyunsaturated fatty acids. NVNM use was greater in boys than in girls (3.9% vs 3.3%), and greater in older children than in younger children (Ptrend < .0001), the opposite of what was observed with VM-only dietary supplement use. Although both user groups shared 2 primary motivations, both motivations were reported by a significantly greater percent of vitamin and/or mineral dietary supplement users vs NVNM users: to maintain health (38.7% vs 23.1%) and to improve health (33.1% vs 22.6%). NVNM users were much more likely to use dietary supplement for relaxation, stress, and sleep; for mental health; and for colon and bowel health. CONCLUSIONS Although the prevalence of any dietary supplement and VM-only dietary supplement use among US children has both remained stable, the prevalence of NVNM use has increased substantially over time. Yet, NVNM use remains relatively low overall. NVNM use exhibited different patterns by sex, age, and motivations when compared with vitamin and/or mineral dietary supplement use. Despite increasing NVNM use, high-quality evidence supporting their use is lacking, especially in children.
Antitrust Immunity Grants to Joint Venture Agreements: Evidence from International Airline Alliances

This article provides evidence from the airline industry on the competitive effects of grants of antitrust immunity by regulatory agencies to certain joint venture agreements. In the airline industry, the U.S. Department of Transportation retains the statutory authority to approve and immunize from the U.S. antitrust laws, under a public interest standard, joint venture agreements relating to international air transportation. Agreements subject to this statute include international airline alliances, which are marketing joint ventures between carriers worldwide. The evidence based on data for the period 2005-2011 shows that recent grants of antitrust immunity to international airline alliances affecting U.S.-E.U. passengers would have raised concerns under an antitrust standard.
Discovery of Biologically Active Oncologic and Immunologic Small Molecule Therapies using Zebrafish: Overview and Example of Modulation of T Cell Activation

Zebrafish models continue to gain popularity as in vivo models for drug discovery. Described in this overview are advantages and challenges of zebrafish drug screening, as well as a novel in vivo screen for immunomodulatory compounds using transgenic, T cell reporting zebrafish larvae designed for discovery of compounds targeting T cell leukemia. This assay system allows rapid screening of large numbers of compounds while avoiding the pitfalls of assays based on cell cultures, which lack biologic context and are afflicted by genomic instability. The rationale for this approach is based on similarities of immature normal T cells and developmentally arrested, malignant lymphoblasts in mammalian species. The screening algorithm has been used to identify a nontoxic compound with activity in both acute leukemia models and models of multiple sclerosis, demonstrating the utility of this screening procedure.