cssi/SciSciGPT-SciSciNet huggingface dataset:
4π Noncoplanar Stereotactic Body Radiation Therapy for Head-and-Neck Cancer: Potential to Improve Tumor Control and Late Toxicity

Purpose To evaluate the potential benefit of 4π radiation therapy in recurrent, locally advanced, or metastatic head-and-neck cancer treated with stereotactic body radiation therapy (SBRT). Methods and Materials Twenty-seven patients with 29 tumors who were treated using SBRT were included. In recurrent disease (n=26), SBRT was delivered with a median 44 Gy (range, 35-44 Gy) in 5 fractions. Three patients with sinonasal mucosal melanoma, metastatic breast cancer, and primary undifferentiated carcinoma received 35 Gy, 22.5 Gy, and 40 Gy in 5 fractions, respectively. Novel 4π treatment plans were created for each patient to meet the objective that 95% of the planning target volume was covered by 100% of the prescription dose. Doses to organs at risk (OARs) and 50% dose spillage volumes were compared against the delivered clinical SBRT plans. Local control (LC), late toxicity, tumor control probability (TCP), and normal tissue complication probability were determined. Results Using 4π plans, mean/maximum doses to all OARs were reduced by 22% to 89%/10% to 86%. With 4π plans, the 50% dose spillage volume was decreased by 33%. Planning target volume prescription dose escalation by 10 Gy and 20 Gy were achieved while keeping doses to OARs significantly improved or unchanged from clinical plans, except for the carotid artery maximum dose at 20-Gy escalation. At a median follow-up of 10 months (range, 1-41 months), crude LC was 52%. The 2-year LC of 39.2% approximated the predicted mean TCP of 42.2%, which increased to 45.9% with 4π plans. For 10-Gy and 20-Gy dose escalation, 4π plans increased TCP from 80.1% and 88.1% to 85.5% and 91.4%, respectively. The 7.4% rate of grade ≥3 late toxicity was comparable to the predicted 5.6% mean normal tissue complication probability for OARs, which was significantly reduced by 4π planning at the prescribed and escalated doses. Conclusions 4π plans may allow dose escalation with significant and consistent improvements in critical organ sparing, tumor control, and coverage.
Mechanisms of Caspase-Independent Neuronal Death: Energy Depletion and Free Radical Generation

Cultured rat embryonic cortical neurons undergo apoptosis when treated with the topoisomerase-I inhibitor camptothecin. Pharmacological or molecular caspase inhibition prevents apoptosis, but the neurons still die in a delayed nonapoptotic manner. Here we examine the mechanisms leading to such caspase-independent death, focusing on events related to mitochondrial malfunction, which accompanies this delayed death. Given that mitochondria are the major source of ATP in primary neurons, we examined the cellular energy state. Mitochondrially generated ATP was specifically reduced in neurons treated with camptothecin and Boc-aspartyl-fluoromethylketone. Augmentation of cellular ATP by manipulation of the glucose content in the cultures led to an increase in survival specifically in delayed caspase-independent but not early caspase-dependent death. As another possible consequence of mitochondrial malfunction, we found an induction of reactive oxygen species in delayed death. The free radical scavenger Tempol, but not other classes of antioxidants, reduced oxidative stress and promoted survival. Other potential events known to be a direct or indirect consequence of mitochondrial dysfunction, such as the induction of autophagy, release of apoptosis-inducing factor, or opening of the mitochondrial permeability transition pore, were not found to play a significant role in caspase-independent neuronal death. Combining the strategies of increasing intracellular ATP and reducing free radicals led to an additive increase in neuronal survival. We conclude that energy failure and free radical generation contribute to caspase-independent neuronal death. Both could represent potential targets for therapeutic interventions complementary to caspase inhibition.
High efficiency, multiplication free approximation of arithmetic coding

An alternative procedure for reducing the computational complexity, which is applicable to both binary and multialphabet arithmetic coding, is described and its performance analysed with respect to the small increase in code length. >
Opioid-induced hyperalgesia method is a clinically relevant issue.

The manuscript by Mercadante et al. (1) on opioid-induced hyperalgesia after rapid titration with intravenous morphine: switching and re-titration to intravenous methadone is not only interesting, but also provides clinically relevant information. As evidenced by multiple publications, opioid-induced hyperalgesia is no longer an extraneous research phenomenon. Its clinical relevance and importance are increasingly recognized (2,3).
GDF3, a BMP inhibitor, regulates cell fate in stem cells and early embryos.

The TGFβ superfamily of ligands plays key functions in development and disease. In both human and mouse embryonic stem cells, a member of this family, GDF3, is specifically expressed in the pluripotent state. We show that GDF3 is an inhibitor of its own subfamily, blocks classic BMP signaling in multiple contexts, interacts with BMP proteins and is expressed specifically in the node during gastrulation in a pattern consistent with BMP inhibition. Furthermore, we use gain- and reduction-of-function to show that in a species-specific manner, GDF3 regulates both of the two major characteristics of embryonic stem cells: the ability to maintain the undifferentiated state and the ability to differentiate into the full spectrum of cell types.
Market discipline prior to bank failure

This paper examines pricing behavior for bonds issued by bank holding companies in the period prior to failure of their bank subsidiaries. The results indicate that bond prices are related to the financial condition of the issuing bank holding companies, and that bond spreads start rising as early as six quarters prior to failure as the issuing firm’s financial condition and credit rating deteriorate. Strong market discipline exists during this critical period— bond spreads for troubled banking organizations are many times those of healthy ones. Our results suggest that bond spreads could potentially be useful to bank supervisors as a warning signal from the financial markets. In addition, our finding implies that the proposals to require bank holding companies to issue publicly traded debt in a greater volume and frequency will likely enhance market discipline in the banking system when it is most needed. © 2001 Elsevier Science Inc. All rights reserved.
Three algorithms for computing the 2-D discrete Hartley transform

In this paper, three algorithms based on the method of vector and paired transforms for dividing the computation of the nonseparable two-dimensional discrete Hartley transform (2-D DHT) into the "minimal" number of the one-dimensional (1-D) DHT's are presented. The computational complexity of the proposed method is analyzed, and the comparative estimates revealing the efficiency of the proposed algorithms with respect to the known algorithms are given.
Development of Turn and Turn Measurement Concepts in a Computer-Based Instructional Unit

This study investigated the development of turn and turn measurement concepts within a computer-based instructional unit. We collected data within two contexts, a pilot test of this unit with four third graders and a field test in two third grade classrooms. We conducted paper-and-pencil assessments, interviews, and interpretive case studies. Turns were less salient for children than ‘forward’ and ‘back’ motions. Students evinced a progressive construction of imagery and concepts related to turns. They gained experience with physical rotations, especially rotations of their own bodies. In parallel, they gained limited knowledge of assigning numbers to certain turns, initially by establishing benchmarks. A synthesis of these two domains — turn-as-body-motion and turn-as-numbe — constituted a critical juncture in learning about turns for some students. Some common misconceptions, such as conceptualizing angle measure as a linear distance between two rays, were not in evidence. This supports the efficacy and usefulness of instructional activities such as those employed.
Open-Ended Activities and Their Role in Maintaining Challenge:

This paper examines the use of open-ended activities as a strategy for providing differentiated instruction and challenge for identified gifted students. In a qualitative study of open-ended activi...
Calculation of the Detection Probability for a Statistically Located Target

This paper presents a method of computing the cumulative probability of detection of a statistically located target. The method is completely analytic and is based on a very simple model. The curve which relates the single scan probability of detection to the target-interceptor range is replaced by the function which is 1.0 up to some critical range and 0 thereafter. The critical range is that value which results in equal areas under the two curves. A factor AR is calculated which depends on scan angle, closing velocity and scan time, and which approximates the decrease in effective range due to nonzero scan time and closing velocity. Finally, a cumulative probability of detection is calculated using an assumed target distribution. An ?exact? evaluation via a digital computer takes into account the actual single scan detection probability (as a function of range), the effect of multiple scans, flyback time, scan time variation with angle, and closing velocity as well as the target distribution. A comparison of the results obtained by the two methods show the simple analytical model to be sufficiently accurate for all but the most exacting analyses.
Cultural Awareness: Enhancing Counselor Understanding, Sensitivity, and Effectiveness With Clients Who Are Deaf

During their professional career, counselors may encounter a client who is deaf; however, they may feel unprepared to work effectively with this population. Counselors who have an understanding of individuals who are deaf through their history, language, and other important considerations might be better prepared to work with this unique and underserved population. A lo largo de su carrera profesional, los consejeros pueden encontrarse con un cliente que sea sordo; sin embargo, puede que no se sientan preparados para trabajar efectivamente con esta poblacion. Aquellos consejeros que tienen un conocimiento de los individuos que son sordos a traves de su historia, lenguaje y otras consideraciones importantes podrian estar mejor preparados para trabajar con esta poblacion singular y desatendida.
A large cellular angiofibroma of the male pelvis presenting with obstructive voiding: A case report and review of the literature.

Cellular angiofibromas (CAF) are rare, benign soft-tissue tumours. The diagnosis of CAF is important given the heavy resemblance to other tumors. Herein, we describe the case of a rapidly growing, very large (13.5 cm) CAF located in the deep pelvis of a middle-aged male who presented with difficulty voiding.
Precision transmittance measurements on ferrites in millimeter waves

This paper presents transmittance spectra and complex magnetic permeability and dielectric permittivity parameters of pure and mixed powdered barium ferrites, nickel zinc manganese ferrites and nickel cobalt copper ferrites in a broad-band millimeter wave frequency range. A free space, millimeter wave magneto-optical approach has been successfully employed for precise characterization of ferrite materials. Frequency dependences of the magnetic permeability of ferrites have been calculated using Schlomann's equation for partially magnetized ferrites.
Altered mucopolysaccharide metabolism in organ cultures of fetal hamster bones infected by the H-1 strain of parvovirus†

Infection with the H-1 strain of parvovirus results in death and deformities in hamster embryos, retardation of skeletal growth and development in immature hamsters, and delayed repair of osseous wounds in older animals. Several aspects of this interference with bone growth can be reproduced as a laboratory model by infection of organ cultures of fetal hamster tibiae with H-1 virus. To investigate the pathogenesis of this virus-induced retardation of skeletal growth, the incorporation and release of 35S by infected and control tibiae was measured in this organ culture model to determine the effect of H-1 virus infection on the rates of synthesis and loss of mucopolysaccharides by fetal bone. Ash weights and mineral-free dry weights of infected and control bones were also compared to detect differences in degrees of mineralization and cartilage formation. By these methods, growth retardation was found to be associated with decreased cartilage formation and increased synthesis and loss of mucopolysaccharides or their components. No difference was found between the mineral contents of infected and control bones. It is proposed that H-1 virus infection interferes with formation of the matrix of cartilage and that intensified 35S incorporation reflects a compensatory but ineffective effort to reverse this inhibition by increasing mucopolysaccharide synthesis. Although no quantitative difference was detected between the mineral contents of infected and control bones, it is suggested that disordered matrix formation may contribute to the delayed or incomplete mineralization of osseous tissues that occurs during later stages of maturation in this animal model of virus-induced dwarfism.
Methodologist as arbitrator: Five models for Black-White differences in the causal effect of expectations on attainment

When progress in applied research slows because opposing coalitions of investigators privilege their favored models, methodologists can contribute by addressing a tractable unresolved question that is relevant to all competing positions. In this article, the literature on educational attainment is addressed, broadly by focusing on alternative positions on the need to model students’ own beliefs and more narrowly by attempting to answer a classic question that emerged in debates over the power of status attainment approaches: Why is the relationship between educational expectations and subsequent educational attainment weaker for Blacks than for Whites? Five complementary models of the causal effect of expectations on attainment are offered: a traditional path model, an average effects instrumental variable model, a counterfactual analysis of bounds, a rational expectations forecasting model, and a panel data model of updated expectations.
Rapid Diagnosis of Lung Cancer from Palpable Metastases by Needle Thrust

This study encourages the use of percutaneous FNB to diagnose and stage advanced lung cancer in patients with palpable metastases in supraclavicular lymph nodes or soft tissues. Percutaneous FNB of metastases is much easier to learn than transthoracic needle aspiration: the superficial target is anchored and sampled with multiple passes using a short needle grasped directly in the fingers. It is fast, accurate, economical and nearly free of risk and pain. The technique saves time and money because it is the only procedure needed by many patients with palpable disease in stage IIIB and IV. Bronchoscopy, transthoracic needle aspiration and open surgical biopsy thus can be avoided in most patients with palpable metastases. Prompt diagnosis by FNB of metastases speeds palliation for patients with urgent need. Tumor cell type from FNB correlated with cytologic findings from sputum samples, bronchoscopy specimens and autopsy results.
Unique Failure Modes from use of Sn-Pb and Lead-Free (mixed metallurgies) in PCB Assembly: CASE STUDY

Printed Circuit Board (PCB) assemblies are moving toward lead-free (LF) alloys and away from the traditional Sn-Pb alloy [1]. This change is creating new and unique failure modes as the process adapts to accommodate the higher temperatures of the new process [2]. In addition, mis-processed lots are more likely due to the complexity of assembling a mix of Sn-Pb and leadfree solders, components, PCBs, solder pastes, and fluxes. This case study helps to highlight the challenge and provides an example of what can happen, how to detect it, and how the defects can cause reliability failures.
Reflections on the Scientific Study of Meaning in Life

This article examines four questions central to the scientific study of meaning in life: First, what are some key challenges faced in the scientific study of meaning in life? Second, how might appropriate measures of meaning constructs be developed? Third, what are the fundamental process related to meaning making and meaning seeking? Finally, are there individual differences in the need for meaning? We offer our thoughts and reflections in response to each of these questions.
T-Wave Alternans, a Powerful Index for Malignant Ventricular Arrhythmias-Fact or Fiction?

In spite of recent improvement in overall cardiovascular mortality, sudden cardiac death (SCD) remains a formidable clinical challenge. Given the magnitude of the problem of SCD — representing up to 50% of all cardiac deaths — cardiologists have long struggled to identify individuals at specific risk for SCD [1]. Traditional strategies have focused on the very-high-risk subgroups in which SCD rates are high. These include survivors of acute myocardial infarction (AMI), and populations such as those studied in MADIT [2] and AVID [3] trials. This strategy has limited population impact, however, because it addresses only a small part of the spectrum of SCD risk. For example, 20%–30% of the population with known or unsuspected coronary artery disease experience SCD as the first clinically recognized manifestation of the disease [1].
Pulse dynamics in optical fibers with random dispersion

Wo consider pulse propagation in an optical fiber link with/without dispersion management in the presence of random variation of chromatic dispersion. We propose a technique to stabilize pulse deterioration due to this dispersion randomness.
General and Specific Perceived Locus of Control in Alcoholics

50 alcoholics were administered the I-E scale and a specially constructed scale to determine the perceived locus of control for their drinking behavior. It was hypothesized and found that alcoholic...
What Does a Gamer Look Like? Video Games, Advertising, and Diversity:

Recent years have seen changes to the video game industry and the image of video game players. There are more games on the market and a larger variety of ways to play those games. Yet, despite market shifts, authors such as Shaw demonstrate that there are still tensions surrounding gamer identification. Even as next-generation systems (such as the Xbox One, the PlayStation 4, and the Wii U) and casual gaming take hold of the market, tension remains between the perceptions of who is playing versus the reality of actual players. In our study, we perform a content analysis of video game commercials in 2013 to explore questions of diversity—particularly in terms of portrayals of the player’s sex and ethnicity—to consider how the gamer is represented in terms of physical and behavioral attributes.
Afterword: toward pluralist policies, practices, and research

Due to globalization, technological advances, and continual migration patterns, educators and policy makers around the world have to deal with increasingly complex teaching and learning contexts th...
Tolerance of the Chick to Excess Dietary Cadmium as Influenced by Dietary Cysteine and by Experimental Infection with Eimeria Acervulina

Three experiments were conducted with 9-d-old crossbred chicks to determine the effect of supplemental L-cysteine.HCl.H2O on tolerance to excess dietary Cd. Cd levels of 30 or 60 mg/kg added to a fully fortified corn-soybean meal diet depressed both body weight gain and gain:feed ratio and increased kidney Cd concentration. Supplemental cysteine (i.e., .59% L-cysteine.HCl.H2O) did not alleviate the depression of weight gain or gain:feed ratio due to Cd feeding but did decrease kidney Cd accumulation. Eimeria acervulina infection (i.e., duodenal coccidiosis) depressed rate and efficiency of weight gain and resulted in increased Cd concentrations in kidney tissue. Cystein supplementation increased kidney cadmium concentration even further in E. acervulina-infected birds.
Highlights from the 65th American College of Cardiology Annual Scientific Session (ACC 2016)

This year's American College of Cardiology Scientific Session (ACC 2016) featured a good number of studies on drug therapies in both primary and secondary preventive settings. In this update, we will present some of the studies that may be of particular significance to the practising physician. In the preventive section, the HOPE-3 (Heart Outcomes Prevention Evaluation 3) trial stole the limelight, first and foremost by strengthening faith in statins—this time by extending their potential benefit to racially and ethnically diverse subjects without cardiovascular disease who did not necessarily have elevated levels of LDL-cholesterol, C-reactive protein, hypertension, or diabetes.1 In the cholesterol-lowering arm of the study, 5874 women aged ≥60 years and 6831 men aged ≥55 years with an intermediate risk profile were randomly assigned to receive either rosuvastatin 10 mg once daily or placebo. The mean baseline LDL-cholesterol level was ∼128 mg/dL, and was ∼30 mg/dL lower in the rosuvastatin arm than in the placebo arm at the end of the trial. After a median follow-up of 5.6 years, the first co-primary endpoint (the composite of myocardial infarction, stroke, and cardiovascular death) occurred significantly less frequently in the rosuvastatin group than in the placebo group [3.7% vs. 4.8%, hazard ratio (HR) 0.76, 95% confidence interval (CI) 0.64–0.91; P = 0.002]. The findings were consistent among pre-specified subgroups. Statin therapy was well tolerated, with an absolute excess of only 1.1% (5.8% vs. 4.7%, P = 0.005) for muscle pain or weakness. Conversely, HOPE-3 left us less optimistic regarding blood pressure lowering in such individuals.2 The two-by-two factorial design allowed for randomization of the study population to low-dose antihypertensive therapy with candesartan 16 mg per day plus hydrochlorothiazide 12.5 mg per day vs. placebo. At 5.6 years, active treatment resulted in an average blood pressure lowering of 6.0/3.0 mmHg above … [↵][1]*Corresponding author. Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. Tel: +1 857 307 1992, Email: dlbhattmd{at}post.harvard.edu [1]: #xref-corresp-1-1
The intestinal microbiome and surgical disease.

As we have seen throughout this monograph, microbes play a key role in both human health, disease, response to surgery and pharmacologic intervention. Advancing the understanding of these complex relationships is in its infancy. Technological advances in analysis, large data management and interpretation of data are rapidly evolving to address disease states which have eluded investigator and clinicians. What has been learned so far, however is both exciting and humbling.
Diagnostic imaging of benign and malignant neck masses in children—a pictorial review

Neck masses are frequently encountered in pediatric medicine, and can present a diagnostic dilemma for the clinicians involved. There are several means by which neck masses in children can be subdivided, for example by age at presentation, anatomical location including compartments and fascia of the neck, their classical appearance when imaged, or by etiology. When imaging children the clinicians must be mindful of radiation exposure and as such ultrasound (US) is often attempted first. Cross sectional imaging can be helpful for problem solving with CT being particularly useful for assessing the patient in more acute scenarios, for example when there is airway compromise. Nuclear medicine scintigraphy has a role in specific circumstances and can aid in staging in the presence of malignancy. If required, additional acquisition by means of magnetic resonance imaging (MRI) and computed tomography (CT) can be considered. This pictorial review describe the diagnostic imaging of (I) congenital and Developmental Pathologies, including thyroglossal duct cyst, branchial cleft cyst, cystic hygroma, dermoid cyst, thymic cyst and ectopic thymus; (II) neoplastic lesions, including hemangiomas and vascular malformations, pilomatrixoma, neurofibroma, neuroblastoma, rhabdomyosarcoma, papillary thyroid cancer, lymphoma & leukemia; (III) neck masses of Infective causes, including lymphadenitis, retropharyngeal and peritonsilar abscess, salivary gland inflammation; and (IV) other miscellaneous lesions, including ranula, sternocleidomastoid fibromatosis coli, and goiter. Neck masses are common in the pediatric population with a broad and varied differential; malignant etiologies are less frequently encountered when compared with adults but an awareness of its potential is important when reviewing imaging.
Chronic Arsenic-Induced Metabolic Syndrome: A Role for Prolonged Nrf2 Activation and Mitochondrial Metabolism

Chronic exposure to inorganic arsenic, mainly via drinking water or contaminated food, is a global health problem linked to increased risk of cardiovascular disease, kidney disease, type II diabetes, and certain types of cancer. Among the pathologies associated with prolonged exposure to arsenic is metabolic syndrome, which is defined by a group of risk factors including dyslipidemia, insulin resistance, and inflammation. Two major contributors to metabolic syndrome are mitochondrial dysfunction and increased oxidative stress. One of the main antioxidant defense pathways against oxidative stress is the NRF2 pathway. However, emerging evidence also supports a role for NRF2 in mediating mitochondrial structure and function as well. While the role of NRF2 in metabolic syndrome is controversial, it has been shown that KEAP1-knockdown (KEAP1-KD) mice, which have constitutively active NRF2, fed a high fat diet, exhibit increased markers of metabolic syndrome, thus inferring prolonged activation of NRF2 could play a key role in driving this syndrome. Previously, our group has shown that arsenic inhibits autophagy, resulting in the prolonged activation of NRF2. Here, we show that arsenic-induced activation of NRF2, or constitutive activation of NRF2 in KEAP1 knockout cells, results in fragmentation of the mitochondrial network. Interestingly, NRF2 knockout cells have fused mitochondria that are resistant to arsenic-induced fragmentation, indicating NRF2 may regulate changes to the mitochondrial network during stress. Arsenic treatment also prevents the mitophagic removal of fragmented mitochondria. Furthermore, pretreatment with rapamycin, an autophagy activator, prevented arsenic-mediated autophagy inhibition, and restored NRF2 to basal levels. These findings indicate that NRF2 levels can directly affect the mitochondrial network, which could play a key role in mediating mitochondrial function and cellular metabolism during prolonged exposure to arsenic. Furthermore, pharmacological activation of the autophagy pathway to restore NRF2 homeostasis, or pharmacological inhibition of mitochondrial fission could be viable therapeutic strategies to treat metabolic syndrome.
Hospital readmission after surgical cytoreduction for epithelial ovarian carcinoma: An assessment of risk.

e15545 Background: Hospital readmissions are common, possibly avoidable, and may be used as a metric for assessing an institution’s quality of care. We performed a retrospective analysis to determi...
Enhanced chromatin accessibility of the dosage compensated Drosophila male X-chromosome requires the CLAMP zinc finger protein

The essential process of dosage compensation is required to equalize gene expression of X-chromosome genes between males (XY) and females (XX). In Drosophila, the conserved Male-specific lethal (MSL) histone acetyltransferase complex mediates dosage compensation by increasing transcript levels from genes on the single male X-chromosome approximately two-fold. Consistent with its increased levels of transcription, the male X-chromosome has enhanced chromatin accessibility, distinguishing it from the autosomes. Here, we demonstrate that the non-sex-specific CLAMP (Chromatin-linked adaptor for MSL proteins) zinc finger protein that recognizes GA-rich sequences genome-wide promotes the specialized chromatin environment on the male X-chromosome and can act over long genomic distances (~14 kb). Although MSL complex is required for increasing transcript levels of X-linked genes, it is not required for enhancing global male X-chromosome chromatin accessibility, and instead works cooperatively with CLAMP to facilitate an accessible chromatin configuration at its sites of highest occupancy. Furthermore, CLAMP regulates chromatin structure at strong MSL complex binding sites through promoting recruitment of the Nucleosome Remodeling Factor (NURF) complex. In contrast to the X-chromosome, CLAMP regulates chromatin and gene expression on autosomes through a distinct mechanism that does not involve NURF recruitment. Overall, our results support a model where synergy between a non-sex-specific transcription factor (CLAMP) and a sex-specific cofactor (MSL) creates a specialized chromatin domain on the male X-chromosome.
Dataflow based Near Data Computing Achieves Excellent Energy Efficiency

The emergence of 3D-DRAM has rekindled interest in near data computing (NDC) research. This article introduces dataflow processing in memory (DFPIM) which melds near data computing, dataflow architecture, coarse-grained reconfigurable logic (CGRL), and 3D-DRAM technologies to provide high performance and very high energy efficiency for stream oriented and big data application kernels. The application of dataflow architecture with a CGRL implementation provides a flexible, energy efficient computing platform. The initial evaluation presented in this paper shows an average speedup of 5.5 is achieved with an energy efficiency factor of 460.
The effect of workforce assignment on performance: Evidence from home health care.

Abstract Effective workforce assignment has the potential for improving performance. Using novel home health data combining provider work logs, personnel data, and detailed patient records, we estimate the effect of provider handoffs—a marker of care discontinuity—on hospital readmissions, an important performance measure for healthcare systems. We use workflow interruption caused by attrition and providers’ work inactivity as an instrument for nurse handoffs. We find handoffs to substantially increase hospital readmissions. Our estimates imply that a single handoff increases the likelihood of 30-day hospital readmission by 16 percent and one in four hospitalizations during home health care would be avoided if handoffs were eliminated. Moreover, handoffs are more detrimental for high-severity patients and expedite hospital readmission. The frequency and sequencing of handoffs also affect the likelihood of rehospitalization.
Synergistic effect of low power ultrasonication on antimicrobial activity of cecropin P1 against E. coli in food systems

Abstract Recent studies have shown that both low frequency (20–100 kHz) ultrasonication and antimicrobial peptides (AMPs) treatment processes have a significant advantage in inactivating bacterial cells than the conventional heat treatment due to higher food texture quality of the final product. However, the effect of the combined process has not been fully investigated in complex matrices such as food. In this study, deactivation of Escherichia coli in different concentrations of milk and orange juice were performed using three different treatments: low frequency ultrasonication (20 kHz) at different power levels, antimicrobial peptide Cecropin P1 at different concentrations, and combination of both. The results of all samples showed that the combined treatment is more efficient, reducing the cell density of E. coli up to four orders of magnitude, compared to individual treatments. However, the milk concentration results in lower synergistic effect. This is believed to be due to complexation of milk proteins with Cecropin P1 thus resulting in less availability of the latter for antimicrobial action. This dependence was not observed in orange juice samples. Ultrasonication resulted in insignificant decrease in viscosity, color and vitamin C for both milk and orange juice except at higher power level of 160 W at longer exposure time.
Transfusion errors: scope of the problem, consequences, and solutions

For more than 25 years, ABO transfusion errors in the United States have caused more noninfectious transfusion deaths each year than any other cause. The US ABO error rate is between 1:12,000 and 1:19,000, with a fatality rate between 1:800,000 and 1:1.3 million. In the past 15 years, international research has increased to determine the frequency and nature of the slips and mistakes that result in transfusion errors and possible solutions to reduce them. Solutions include changes in human processes, introducing technologic improvements, and involving professional societies to create national or international performance standards to serve as benchmarks for comparison.
Epidemiology, Diagnosis, and Staging of Esophageal Cancer

Esophageal carcinoma is an uncommon gastrointestinal malignancy with a prevalence rate which is far less than the more common colo-rectal cancers. Whereas the overall incidence of esophageal cancer has risen only gradually with time, in the United States, Canada, and Western Europe, there has been a dramatic change in the distribution of esophageal cancer by cell type (figure 1). Currently esophageal adenocarcinoma has replaced squamous cell carcinoma as the most common tumor diagnosed (1-4). Although esophageal carcinoma, regardless of cell type, continues to be an aggressive malignancy that usually presents in a locally advanced stage, new treatment plans using combination therapies have made significant progress in improving survival for patients with these tumors. These new treatment options, the surge of new cases of adenocarcinoma, and the introduction of new diagnostic modalities, have altered the current approach to the diagnosis and staging of esophageal carcinoma.
Polyamide thin-film nanocomposite membranes with graphene oxide nanosheets: Balancing membrane performance and fouling propensity

Abstract Reverse osmosis (RO) is the fastest growing desalination technology but still suffers from the permeability-selectivity tradeoff of polymeric membranes and the vulnerability of polyamide thin film composite (TFC) membranes to fouling. Membranes incorporating graphene oxide (GO) sheets in the polyamide layer have the potential to address these limitations by providing antifouling and molecular sieving capacities. However, these two properties of GO-based thin film nanocomposite (TFN) membranes originate from different features of GO and optimal TFN composition may differ when designing for improved permeability or fouling resistance. In this study, we evaluated the effect of incorporating GO sheets in the polyamide active layer of TFN membranes on their separation performance and fouling resistance. Increasing the GO loading in TFN membranes increased the antifouling and antimicrobial properties of TFN membranes. On the other hand, a small increase in membrane permeability was observed at low GO loading and decreased with increasing GO content in the active layer. Therefore, the results of this study emphasize the trade-off that exists between improved performance and reduced fouling propensity and the benefits of GO appear higher as an antimicrobial and antifouling additive than a permeability enhancer in TFN membranes.
Teaching elementary social studies during snack time and other unstructured spaces

Abstract It is common practice for social studies in the elementary school day to be integrated into other subject areas, especially language arts. Also common in an elementary school day are unstructured spaces such as snack time or recess. In this paper, we present findings from a larger study on social studies integration within various subject areas to explore how two teachers (first and fifth grade) integrated social studies into unstructured spaces. These teachers integrated social studies concepts and experiences into morning work, community building, snack time, and after-lunch reading to varying degrees. This study provides an inroad for conversation among researchers, teacher educators, and practicing teachers about the ideals and reality of elementary social studies with the hope of deepening students’ experiences.
Environmental disorder can tip the population genetics of range expansions

Abstract Evolutionary dynamics is fundamentally shaped by stochastic processes: spon-taneous mutations enter populations randomly, and the fate of a mutant lineage is determined by the competition between (random) genetic drift and (determin-istic) selection. In populations undergoing range expansions, fluctuations in the reproductive process and the local motion of individuals are enhanced within a small subpopulation at the edge of the population. Range expansions are typically studied in homogeneous environments, but we argue here that the fluctuations at the range edge are susceptible to small-scale environmental heterogeneities that may have a strong effect on the evolutionary dynamics of the expanding population. To show this, we tracked the dynamics of the clones of spontaneous mutations with a tunable fitness effect in bacterial colonies grown on randomly disordered surfaces. We find that environmental heterogeneity on scales much larger than an individual, but much smaller than the total population, can dramatically reduce the efficacy of selection. Time lapse microscopy and computer simulations suggest that this effect is a general consequence of a local “pinning” of the expansion front, whereby stretches of the front are slowed down on a length scale that depends on the structure of the environmental heterogeneity. This pinning focuses the range expansion into a small number of individuals with access to expansion paths, increasing the importance of chance and thus limiting the efficacy of selection.
Listening for Intimate Partner Violence: A Call for Empathic Empowerment

In the midst of writing this essay, my social media landscape was set on fire with two words: “me too.” Countless women (primarily, though not only women) recounted their experiences of violence en...
CHAPTER 103 – Protein Phosphatase 1 Binding Proteins

All forms of PP1 holoenzymes contain a similar, highly con-served catalytic subunit but differ in the associated regulatory subunits. The large number of associating proteins provides compelling evidence that the distinctive features of different PP1 holoenzymes reside in the regulatory components. Thus, functionally distinct forms are generated by combination of a similar catalytic component with different regulatory subunits that are responsible for targeting the enzyme to specific cellular locales, for conferring substrate specificity, or for controlling the enzyme activity. The large number of targeting/ regulatory subunits of PP1 can thus account for the pleiotropic function of the type 1 phosphatase in the cell.
From Antisemitism to Anti-Zionism: The Past & Present of a Lethal Ideology

Intense debates are underway in academic circles as well as in the public arena about the connections between antisemitism and anti-Zionism. Just how the two may be linked has become an issue of on...
ER+/HER2+ Breast Cancer Has Different Metastatic Patterns and Better Survival Than ER-/HER2+ Breast Cancer.

Abstract Background Human epidermal growth factor receptor 2–positive (HER2+) breast cancer is generally treated with HER2-targeted therapy combined with chemotherapy. Patients with HER2+ and estrogen receptor–positive (ER+) cancer are additionally treated with long-term hormone therapy. This study examined the metastatic pattern and prognosis of both ER+/HER2+ and ER−/HER2+ breast cancer. Patients and Methods A total of 54,147 patients with HER2+ breast cancer from the National Cancer Data Base (NCDB, 2010-2013) and 31,946 patients with HER2+ breast cancer from the Surveillance, Epidemiology, and End Results Program (SEER, 2010-2014) were examined. Sites of metastasis and overall survival (OS) were examined in the NCDB, while OS and breast cancer–specific survival were examined in the SEER database. Results Compared to ER−/HER2+ breast cancer, ER+/HER2+ breast cancer was more likely to metastasize to bone but less likely to brain, liver, and lung and less likely to result in multiple metastases. In univariate analysis based on the NCDB, patients with ER−/HER2+ breast cancer had worse OS in all metastasis subsets, including patients who received HER2-targeted therapy. This poor survival for ER−/HER2+ persisted in patients with metastasis to bone and lung, and multiple metastases. In multivariate analysis adjusting for age, tumor grade, surgery, chemotherapy, HER2-targeted therapy, and hormone therapy, ER−/HER2+ patients with bone metastasis still had worse OS. In the SEER, ER−/HER2+ patients had both worse OS and breast cancer–specific survival in univariate analysis. Conclusion This large study showed patients with ER+/HER2+ and ER−/HER2+ breast cancers had different metastatic patterns. Patients with ER−/HER2+ breast cancer may require more aggressive treatment.
Stories from the Heart: Missouri's African American Heritage

Review of: " Stories from the Heart: Missouri's African American Heritage," compiled by Gladys Caines Coggswell
Sensory Amplitude Electrical Stimulation via Sock Combined With Standing and Mobility Activities Improves Walking Speed in Individuals With Chronic Stroke: A Pilot Study

Objective: To determine if sensory amplitude electrical stimulation (SES) delivered via sock electrode combined with standing and mobility activities improved gait speed, sensation, balance, and participation in chronic stroke. It was hypothesized that SES would enhance the effectiveness of exercise, resulting in reduced impairment and improved function. Design: Case Series. Setting: Home-based intervention. Participants: Thirteen adults (56.5 + 7.84 years old) with chronic stroke (8.21 + 4.36 years post) and hemiparesis completed the study. Participants were community ambulators. Intervention: Participants completed 6 weeks of self-administered SES delivered via sock electrode concurrent with standing and mobility activities for a minimum of 5 days/week for 30-min, twice daily. Outcome Measures: Berg Balance Scale (BBS), Stroke Rehabilitation Assessment of Movement-LE subscale (STREAM), 10 Meter Walk Test (10 MWT), Activities-Specific Balance Confidence Scale (ABC), Stroke Impact Scale (SIS), Perceptual Threshold of Electrical Stimulation (PTTES), and Monofilament testing were administered at pre-test, post-test, and 3-month follow up. Results: Baseline sensory scores and change scores on functional outcomes were analyzed using Pearson Product-Movement Correlation Coefficients, Friedman test, and Linear mixed models. There was a significant change with 10 MWT self-selected pace (Friedman's p = 0.038). Pre-post intervention changes in other outcome measures were not significant. According to the Cohen's effect size classification, there were medium effect sizes for both the STREAM-LE and Monofilaments. Conclusion: The use of home-based SES via sock electrode combined with standing and mobility activities may contribute to improve gait speed in chronic stroke.
Patient Factors Affecting Emergency Department Utilization and Hospital Readmission Rates After Primary Anterior Cervical Discectomy and Fusion: A Review of 41,813 cases.

STUDY DESIGN Retrospective database analysis. OBJECTIVE To identify preoperative risk factors for emergency department (ED) visit and unplanned hospital readmission after primary anterior cervical discectomy and fusion (ACDF) at 30 and 90 days. SUMMARY OF BACKGROUND DATA Limited data exist to identify factors associated with ED visit or readmission after primary ACDF within the first 3 months following surgery. METHODS Patients undergoing ACDF from 2005 to 2012 were identified in the Statewide Planning and Research Cooperative System database. Multivariable regression models were created based on patient-level and surgical characteristics to identify independent risk factors for hospital revisit. RESULTS Of 41,813 patients identified, 2514 (6.0%) returned to the ED within 30 days of discharge. Risk factors included age 1, length of stay (LOS) greater than 1 day (OR 1.23), and fusion of > 2 levels (OR 1.17). Four thousand six hundred nine (11.0%) patients returned to the ED within 90 days. Risk factors mirrored those at 30 days. Patients having private insurance or those discharged to rehab were less likely to present to the ED. One thousand three hundred ninety-four (3.3%) patients were readmitted by 30 days. Risk factors included male sex, Medicare, or Medicaid insurance (OR 1.71 and 1.79 respectively), Charlson comorbidity index > 1, discharge to a skilled nursing facility (OR 2.90), infectious/pathologic (OR 3.296), or traumatic (OR 1.409) surgical indication, LOS > 1 day (OR 1.66), or in-hospital complication. 2223 (5.3%) patients were readmitted by 90 days. Risk factors mirrored those at 30 days. No differences in readmission were seen based on race or number of levels fused. Patients aged 18 to 34 were less likely to be readmitted versus patients older than 35. CONCLUSION Insurance status, comorbidities, and LOS consistently predicted an unplanned hospital visit at 30 and 90 days. Although nondegenerative surgical indications and in-hospital complications did not predict ED visits, these factors increased the risk for readmission. LEVEL OF EVIDENCE 3.
The number of breeders explains genetic connectivity in an endangered bird

Connectivity is central to ecology and evolution as it focuses on the movement of individuals or genes across landscapes. Genetic connectivity approaches aim to understand gene flow but often estimate it indirectly based on metrics of genetic differentiation, which can also be affected by other evolutionary forces such as genetic drift. Gene flow and genetic drift are driven by separate ecological mechanisms with potentially differing effects on genetic differentiation and interpretations of genetic connectivity. The ecological mechanisms contributing to gene flow and genetic drift are primarily effective dispersal, or movement followed by successful reproduction, and the number of breeders in a local population, Nb , respectively. Yet, rarely are these ecological mechanisms and genetic connectivity measured simultaneously across landscapes. We examine the roles of effective dispersal and Nb on genetic connectivity across the entire range of the endangered snail kite (Rostrhamus sociabilis plumbeus), between 2006-2015. We find that both Nb and effective dispersal are important predictors of genetic connectivity across this landscape, but that Nb has a 3 × stronger effect on genetic connectivity. Furthermore, Nb is positively correlated with heterozygosity and allelic richness within patches, suggesting a potentially important role of genetic drift, in addition to gene flow, on genetic connectivity. These results emphasize that conservation efforts should focus on not only between-patch processes of movement but also within-patch processes regarding habitat quality and local population size for increasing genetic connectivity.