cssi/SciSciGPT-SciSciNet huggingface dataset:
Inactivation of Salmonella spp., pathogenic Escherichia coli, Staphylococcus spp., or Listeria monocytogenes in chicken purge or skin using a 405-nm LED array.

Raw poultry are sometimes contaminated with foodborne pathogens, which can lead to illness in humans. In recent years research has focused on a variety of light technologies to decontaminate food and food contact surfaces during meat and poultry processing. In this study we evaluated the ability of 405-nm light generated from an LED array to inactivate multi-isolate cocktails of either Salmonella spp., pathogenic Escherichia coli, Staphylococcus spp., or Listeria monocytogenes suspended in chicken purge or skin. When exposed to 180 J/cm2 405-nm light at two separate light intensities (300 mW/cm2/s or 150 mW/cm2/s) the maximum pathogen reduction on chicken skin was ca. 0.4 log. When the pathogens were suspended in chicken purge the maximum log reductions ranged from 0.23 to 0.68 log (180 J/cm2; 150 mW/cm2/s) versus 0.69 to 1.01 log (180 J/cm2; 300 mW/cm2/s). Log reductions of each pathogen, when they were subjected to heat shock prior to 405-nm light treatment, were reduced, indicating that thermal effects accounted for much of the bacterial inactivation.
How Should Organizations Promote Equitable Distribution of Benefits from Technological Innovation in Health Care

Technological innovations typically benefit those who have good access to and an understanding of the underlying technologies. As such, technology-centered health care innovations are likely to preferentially benefit users of privileged socioeconomic backgrounds. Which policies and strategies should health care organizations adopt to promote equitable distribution of the benefits from technological innovations? In this essay, we draw on two important concepts-co-creation (the joint creation of value by multiple parties such as a company and its customers) and digitalization (the application of new digital technologies and the ensuing changes in sociotechnical structures and relationships)-and propose a set of policies and strategies that health care organizations could adopt to ensure that benefits from technological innovations are more equitably distributed among all target populations, including resource-poor communities and individuals.
Ego depletion improves insight

Initial acts of self-control can reduce effort and performance on subsequent tasks – a phenomenon known as ego depletion. Ego depletion is thought to undermine the capacity or willingness to engage executive control, an important determinant of success for many tasks. We examined whether ego depletion improves performance on a task that favours less executive control: insight problem solving. In two experiments, participants completed an ego-depletion manipulation or a non-depleting control condition followed by an insight problem-solving task (i.e., matchstick arithmetic). Participants in the depleting condition demonstrated greater insight problem-solving accuracy than those in the non-depleting control condition. Priming theories of willpower did not impact these results. Although ego depletion is widely regarded as a “state of impairment”, attendant decreases in executive control may foster insightful thinking.
Notes on the Stratigraphic Occurrence of the Rudist Durania maxima (Bivalvia: Radiolitidae) in the Smoky Hill Chalk, Western Kansas

Rudist clams were a diverse group of large, atypical marine bivalves that evolved in the warmer waters of the Earth during the Jurassic and became extinct at the end of the Cretaceous. Rudists were generally gregarious and are considered to be the major reef building organisms in equatorial regions during the Late Cretaceous. Durania maxima is the only species of rudist known from the Smoky Hill Chalk where it occurs sparsely as single individuals or small groups, suggesting that it was at the northern extent of its range. Although specimens of this clam have been collected from the chalk since the 1870s, accurate stratigraphic data is lacking on the type and most other specimens discovered since that time. As noted by Williston (1893), Logan (1898), Hattin (1982) and Stewart (1990), D. maxima occurs most frequently in the lower (Upper Coniacian) chalk, and is present throughout the member. Relatively little work has been done on the occurrence of D. maxima in the Western Interior Sea, in part because it occurs outside the normal geographic range of rudists and does not constitute a significant part of the fauna. The history of the discovery and collection of this fossil bivalve in Kansas is reviewed, and two recently collected specimens are reported here with stratigraphic data.
Lumbosacral radiculoplexus neuropathy: Incidence and the association with diabetes mellitus

Objective To determine the previously unknown incidence of lumbosacral radiculoplexus neuropathy (LRPN) and its association with diabetes mellitus (DM). Methods LRPN defined by clinical and electrophysiologic criteria was identified among Olmsted County, Minnesota, residents during a 16-year period (2000–2015) using the unique facilities of the Rochester Epidemiology Project. DM was ascertained using American Diabetes Association criteria. Results Of 1,892 medical records reviewed, 59 patients (33 men, 26 women) were identified as having LRPN. The median age was 70 years (range 24–88 years) and the median time of onset of symptoms to diagnosis was 2 months (range 1–72 months). DM was more frequent in patients with LRPN than in controls (39/59 vs 35/177, p Conclusions LRPN incidence in Olmsted County of 4.16/100,000/y makes LRPN a common inflammatory neuropathy and is higher than that of other immune-mediated neuropathies (acute or chronic inflammatory demyelinating polyradiculoneuropathy, brachial plexus neuropathy) assessed within the same population. DM is a major risk factor for LRPN and thus justifies the continued classification of LRPN into diabetic and nondiabetic forms.
Case Comparisons and Precedence Pools

Having compared contingents on constructed criteria (centroids, representative ranks, and distance domains) to choose candidate contingents, our progressive prioritization process moves to comparison of cases within candidate contingents to choose candidate cases. Both comparison of contingents and comparison of cases within contingents can be seen as selective screening that eliminates cases from contention. This is followed by cross-contingent comparison of candidate cases that brings together the best cases of the better contingents. This combination of candidate cases that crosses contingents is then prioritized and particularized rather than reduced.
Generalized Coordinate Partitioning Methods for Numerical Integration of Differential-Algebraic Equations of Dynamics

Explicit and implicit, stiffly stable numerical integration algorithms based on generalized coordinate partitioning are developed and demonstrated for automated simulation of multibody dynamic systems. The concept of generalized coordinate partitioning is used to parameterize the constraint set with independent generalized coordinates. A stiffly stable, backward differentiation formulas are applied to determine independent generalized coordinates and velocities. Dependent generalized coordinates, velocities, and accelerations, as well as Lagrange multipliers that account for constraints, are explicitly retained in the formulation to satisfy all of the governing kinematic and dynamic equations. The algorithm is shown to be valid and accurate, both theoretically and through solution of a numerical example.
Characterization of glycoproteins: carbohydrate structures of glycoprotein hormones.

Gylcoproteins are a complex group of macromolecules that are widely distributed in nature. They are present virtually in all forms of life and are involved in important biological functions (Wagh and Bahl, 1981; Sharon and Liz, 1982; Kobata, 1984). The importance of the role that the carbohydrates play in the functions of glycoproteins has been fairly well recognized (Ashwell and Harford, 1982; Kalyan et al., 1982; Kalyan and Bahl, 1983). In recent years, considerable progress has been made toward our understanding of the structure, function, and biosynthesis of the carbohydrates (Kornfeld and Kornfeld, 1985). This has been due largely to the refinement in oligosaccharide separation and structural techniques. A vast amount of structural information gathered as a result has revealed that microheterogeneity is of general occurrence in glycoproteins. The function of this microheterogeneity is ambiguous at present. Moreover, it is difficult to reconcile the phenomenon of microheterogeneity with the fact that there is an intimate and precise relationship between structure and function in biological macromolecules. Nevertheless, the existence of microheterogeneity has complicated the structural determination of the carbohydrate prosthetic groups. In the seventies, microheterogeneity was merely considered as an artifact and was ignored during the structural determination of heterosaccharides. Consequently, the structures reported then were average structures and should be reexamined (Kobata, 1984). In this report, the problem of micro-heterogeneity the general strategy for heterosaccharide structural characterization are considered with respect to three glycoprotein hormones: human choriogonadotropin (hCG), ovine luteinizing hormone (oLH), and equine choriogonadotropin (eCG).
Triggering of Mitosis in the Cultured Mammalian Lens by Proteolytic Enzymes

Rabbit lenses were cultured in medium KEI-4 or in KEI-4 containing trypsin, thrombin, or soybean trypsin inhibitor. Lenses were exposed to soybean trypsin inhibitor and/or trypsin (5 μg/ml) for the initial 30 minutes of culture and were subsequently maintained in medium KEI-4 alone for a total of 52 hrs of culture. Whole-mounts of the epithelium were analyzed for mitosis and cell migration.
Physical and Mechanical Hazards

In this chapter we will discuss how to control hazards of such things as contact with machinery, improper storage, blocking of corridors or doors, slipping or tripping, and the use of water and of devices producing electromagnetic radiation. All of these hazards in the laboratory or research facility can certainly be controlled and avoided, especially if laboratory personnel realize the potential for accidents that these hazards produce. Avoiding injury resulting from any of these hazards requires the exercise of caution and common sense in order to maintain a safe environment in the laboratory.
The Costs and Benefits of Transactional Certainty: An Appraisal of Omnicare V. Ncs Healthcare

In Omnicare v. NCS Healthcare, the Delaware Supreme Court recently announced what appears to be a bright-line rule against transactional certainty in mergers and acquisitions. Even in the context of a friendly merger agreement - that is, a negotiated transaction not involving a "change in control" - target boards may not agree to a fully protected merger agreement. Instead, it is now a requirement of law that target boards always include an escape clause, in the form of a fiduciary out, in their merger agreements. As a result, targets can no longer follow a "precommitment strategy," offering contractual certainty as a means of negotiating a better deal for shareholders. This article engages in a close analysis of the NCS opinion, first probing the doctrinal foundations then the policy implications of the majority's holding. As a matter of doctrine, I show that existing precedent neither compels nor supports the bright-line rule announced by the Court. Worse, as a matter of policy, the Court's open hostility to precommitment strategies is likely to harm shareholder welfare. Finally, I draw upon economic theory to propose an alternative rule that would preserve, under certain circumstances, the ability of target boards to follow an affirmative precommitment strategy.
Changing Business Model: From Licensing Fees to Service Agreement

With the establishment of the AO Foundation in 1984, the individual AO Foundation shareholders donated all assets in the form of shares to Synthes AG Chur. While the creation of the AO Foundation affected the governance of the AO, it did not immediately have an impact on the revenue stream that funded the AO’s activities. Over the next 20 years, however, the funding base for the organization was to change completely and a new business model was eventually adopted in 2006.
A hybrid fog-cloud approach for securing the Internet of Things

As the Internet of Things (IoT) continues to grow, there arises concerns and challenges with regard to the security and privacy of the IoT. Malicious attacks such as man-in-the-middle and distributed denial of service (DDoS) are typical threats to the IoT systems. In this paper, we propose a FOg CompUting-based Security (FOCUS) system to provide security for IoT systems against those malicious attacks. The proposed FOCUS system applies a threefold protection mechanism: Firstly, it makes use of the virtual private network (VPN) to secure the communication channels for the IoT devices; Secondly, it applies machine learning-based traffic analysis unit to classify the traffic to be trusted, untrusted and suspicious; Thirdly, it adopts a challenge-response authentication to validate the suspicious traffic source so as to protect the VPN server against potential DDoS attacks. Such a threefold protection mechanism is effective in mitigating various malicious attacks and can provide a high standard security for the IoT system. Furthermore, to improve the system performance, FOCUS is implemented in a hybrid fog-cloud model that achieves a low latency and system response time. In the hybrid fog-cloud model, a selected amount of the protection and validation requests are addressed in the fog that is close to the end users, while the excessive requests are addressed in the cloud. Through this, FOCUS can effectively avoid the long queuing delay caused by the limited computational capacity in the fog implementation. The experimental results show that FOCUS can effectively filter out malicious attacks with low response time and small network cost (e.g., network bandwidth consumption).
Proctectomy in Patients with “Watering Can” Perineum

Perineal wound complications are common after proctectomy for inflammatory bowel disease (IBD). The failure of initial primary healing of perineal wound ranges from 2% to 45% in ulcerative colitis (UC) and up to 36% in Crohn’s disease (CD). The presence of perineal sepsis due to extensive perineal fistulas, the so-called “watering can” perineum, can further complicate healing after proctectomy and contribute to delay in perineal wound closure. While most perineal wounds heal over time, some result in the development of a chronic perineal sinus. The incidence of perineal sinus formation may be as high as 50% in ulcerative colitis and 62% in Crohn’s disease.
Drosophila Aop imposes a delay on E(spl)-mediated repression of Ato during R8 specification

Abstract Drosophila retinal patterning requires the expression of Atonal (Ato) through coordinated regulation of 5’ and 3’ enhancer modules. ato-3’ directs initial expression of Ato which then directs autoregulation via 5’-ato. Notch (N) signaling also regulates 5’-ato, first enhancing Ato expression and later repressing Ato by inducing E(spl) bHLHs. N signaling balances these opposing functions by directing its obligate nuclear transcription factor, Suppressor of Hairless (Su(H)), only in repressing 5’-ato. In this study, we reveal a novel and more nuanced role for Su(H) in its regulation of 5’-ato. During retinal patterning, Su(H) is required for the expression Anterior open (Aop), which, in turn, promotes 5’-ato activity. We demonstrate that Aop is induced early in retinal patterning via N pathway activity, wherein Aop is required cell-autonomously for robust Ato expression during photoreceptor specification. In aop mutants, expression from both ato enhancers is perturbed, suggesting that Aop promotes the Ato autoregulation through maintenance of ato-3’ activity. Clonal analysis indicates that Aop indirectly opposes E(spl)-mediated repression of Ato. In the absence of both Aop and E(spl), Ato expression is restored and the founding ommatidial photoreceptors, R8s, are specified. These findings suggest that N signaling, through a potentially conserved relationship with Aop, imposes a delay on ato repression, thus permitting autoregulation and retinogenesis. Author Summary The eye of the fruit fly has served as a paradigm to understand tissue patterning. Complex intercellular signaling networks cooperate during retinal development to allow cells to become specialized visual-system precursor neurons at a specific time and place. These neurons are precisely spaced within the developing retina and later recruit other cells to form the repeated units that comprise insect eyes. The exact placement of each precursor cell precipitates from the precise regulation of the atonal gene, which is first expressed in a cluster of (10-20) cells before becoming restricted to only one cell from each cluster. The Notch signaling pathway is required for both aspects of atonal regulation, first permitting up-regulation within each cluster, and then the subsequent down-regulation to a single cell. However, the connection between these two modes of Notch signaling had remained unclear. In this report, we have identified that the anterior open gene is required to impose a delay on the restrictive mode of Notch signaling, permitting the initial up-regulation of atonal to occur freely. In flies mutant for anterior open, atonal bypasses its own up-regulation and proceeds directly to its singled-out pattern but with significantly diminished robustness than occurs normally.
GWU NLP at SemEval-2019 Task 7: Hybrid Pipeline for Rumour Veracity and Stance Classification on Social Media.

Social media plays a crucial role as the main resource news for information seekers online. However, the unmoderated feature of social media platforms lead to the emergence and spread of untrustworthy contents which harm individuals or even societies. Most of the current automated approaches for automatically determining the veracity of a rumor are not generalizable for novel emerging topics. This paper describes our hybrid system comprising rules and a machine learning model which makes use of replied tweets to identify the veracity of the source tweet. The proposed system in this paper achieved 0.435 F-Macro in stance classification, and 0.262 F-macro and 0.801 RMSE in rumor verification tasks in Task7 of SemEval 2019.
Design and Performance of a Multiphase Flow Manifold

An experimental and theoretical study is conducted on the design and performance of multiphase flow manifold. An experimental multiphase flow manifold is designed and constructed and 16 experimental runs are carried out to investigate slug dissipation in the manifold. A mechanistic model is developed based on a slug-tracking model for the prediction of the diameter and length of the manifold. Comparison between the developed model predictions and the acquired experimental data shows less than 8% average absolute relative error.
Can We Use Home Sleep Testing for the Evaluation of Sleep Apnea in Obese Pregnant Women

Objective. To evaluate the performance of a type III home sleep testing (HST) monitor including its autoscoring algorithm, in a population of obese pregnant women. Methods. This was an ancillary study of an ongoing prospective study of obese (BMI of ≥30) pregnant women. For the primary study, women undergo serial in-lab polysomnograms (PSG) during pregnancy. Sleep apnea was defined as an apnea hypopnea index (AHI) of ≥ 5 events/hour. A subgroup of women were asked to wear an ApneaLink HST device for 1 night, within 2 weeks of a late pregnancy PSG (≥ 28 weeks’ gestation). The AHI obtained from PSG was compared to the AHI from the HST via autoscoring (HST-auto) as well as the AHI via technician scoring (HST-tech). We calculated Shrout Fleiss Fixed correlation coefficients (ICC) and looked at positive-positive and negative-negative agreement. Results. 43 women were recruited and we obtained 30 valid HST. The mean PSH AHI was 3.3 (±3.2, range 0.5-16.6). Six (20%) women had a positive PSG study. ICCs were 0.78 for HST-auto versus HST-tech, 0.76 for HST-auto versus PSG, and 0.70 for HST-tech versus PSG. Categorical agreement was also strong, with 24/30 (80.0%) for HST-auto versus HST-tech, 25/30 (83.3%) for HST-auto versus PSG, and 23/30 (76.7%) for HST-tech versus PSG. Conclusion. In obese women evaluated in late pregnancy, we found relatively high intraclass correlation and categorical agreement among HST-auto scores, HST-tech scores, and in-lab PSG results obtained within a two-week window. These results suggest that HST may be used to screen pregnant women for OSA.
Comparing No-Show Rates of Neurology Outpatients with and without Parkinson's Disease: A Real-World Assessment of the Parkinsonian Personality Profile.

Background Parkinson's disease (PD) has been hypothesized to be associated with certain personality traits, including conscientiousness and punctuality. However, research aimed at quantifying these traits is largely derived from questionnaire-based personality inventories rather than real-world observations. Objective To explore the presence of a parkinsonian personality profile by assessing the no-show rate of patients with PD versus other neurological disorders. Methods We extracted data from our electronic health record for all neurology appointments over a 78-month interval. Additionally, we obtained primary care appointment data for the same patients over the same timeframe. For each appointment we collected appointment date/time, check-in time, provider, age, sex, insurance type, days between appointment date and scheduling, diagnosis code, and no-show status. Results 19,433 unique patients (400 with PD) accounting for a total of 252,347 outpatient appointments were included in our analysis. The overall no-show rate for PD patients was 3% versus 7.4% for patients with other neurologic disorders (OND). No show rates for PD patients were lower than those with OND for both neurology appointments (2.7% versus 13.6%) and for primary care visits (3.1% versus 5.9%). Conclusions Patients with PD have lower no-show rates than patients with OND. Additionally, the no-show rate for patients with PD did not differ between their neurology and primary care appointments, confirming that patient's personality rather than provider traits account for this difference, and supporting the presence of a parkinsonian personality.
Goal Pursuit, Goal Adjustment, and Pain in Middle-Aged Adults Aging With Physical Disability:

Objective: Aging with physical disability disrupts one's ability to achieve valued goals due to changes in symptoms and function. It is unclear how to cope optimally in this context. This study examined whether two possible strategies-tenacious goal pursuit (TGP) and flexible goal adjustment (FGA)-were associated with reduced pain interference and depressive symptoms and greater well-being, and protected against pain intensity, and FGA was more protective with increasing age and worse physical function. Method: Middle-aged adults with muscular dystrophy, multiple sclerosis, post-polio syndrome, or spinal cord injury (N = 874; MAGE = 58.3 years, range = 46-68; MDISEASEDURATION = 26.2 years, range = 2-67) completed two questionnaires, a year apart. Results: TGP and FGA use was associated with greater well-being. FGA use predicted decreased depressive symptoms. Concurrent use of both predicted decreased pain interference. Discussion: Adults with disability employ a variety of goal management strategies. Findings support TGP and FGA as potential intervention targets for healthy aging with disabilities.
[Breech Presentation: CNGOF Guidelines for Clinical Practice - External Cephalic Version and other Interventions to turn Breech Babies to Cephalic Presentation].

Resume Objectifs Emettre des recommandations de bonnes pratiques cliniques quant a l’efficacite et la securite de la tentative de version par manœuvre externe (VME) et des techniques alternatives de version en cas de presentation du siege. Methode Recherche bibliographique en langue francaise et anglaise a partir des bases de donnees Medline et Cochrane entre 1980 et 2019 et a partir des recommandations de societes savantes internationales. Resultats La tentative de VME etant associee a une diminution du taux de presentation du siege a l’accouchement (NP2) et a une diminution du taux de cesarienne (NP3) sans augmentation de la morbidite maternelle (NP3) et perinatale severe (NP3), il est recommande d’informer les femmes avec une presentation du siege de la possibilite de realiser une tentative de VME (Accord professionnel). Il est recommande de realiser toute tentative de VME dans une structure ou une cesarienne est realisable en urgence (Accord professionnel). La tentative de VME avant 37 SA, en comparaison a une tentative de VME a partir de 37 SA, augmente les chances de presentation cephalique a la naissance (NP2) avec une faible augmentation du risque de prematurite moderee (NP2). En cas de tentative de VME, il est recommande de la realiser a partir de 36 SA (Accord professionnel). Les principaux facteurs associes a la reussite d’une VME sont la multiparite (NP3) et l’absence d’obesite maternelle (NP3). L’utilisation d’une tocolyse IV (β mimetiques ou atosiban), lors d’une tentative de VME ameliore le taux de succes (NP2), augmente le taux de presentation cephalique lors de l’entree en travail (NP2) et reduit le taux de cesariennes (NP2). Il est recommande d’utiliser une tocolyse IV en cas de tentative de VME a terme afin d’en augmenter le taux de succes (Grade B). La tentative de VME etant associee a une augmentation d’anomalies transitoires du rythme cardiaque fœtal (RCF) (NP3), il semble raisonnable de realiser un enregistrement du RCF avant et pendant les 30 minutes qui suivent une tentative de VME (Accord professionnel). En revanche, il n’existe aucune donnee pour recommander un enregistrement du RCF a distance d’une tentative d’une VME (Accord professionnel). Le risque de positivite significative (> 30 mL) du test de Kleihauer apres une tentative de VME etant faible ( Conclusion Au regard des benefices et des risques de la tentative de VME, toutes les femmes avec une presentation du siege a terme devraient etre informees de la possibilite de realiser une tentative de VME.
172-P: MYSTERIOUS “SUBOPTIMAL” FUNCTION OF A DECEASED DONOR (DD) RENAL ALLOGRAFT

Aim To determine the role of alloimmune status of a deceased donor renal allograft with suboptimal graft function. Methods HLA typing was done by rSSOP and antibody assays were done by LabScreen mixed (LSM), LabScreen ID/Flow PRA, Luminex Single Antigen Bead assays (SAB), and by DSA assay using beads coated with donor lymphocyte lysates (GenProbe). Crossmatches were done by Flow cytometry (FC). Biopsy was assessed by histology and C4d staining. Results The recipient had no Class I, II or MICA antibodies from Feb ‘08 till Feb ‘12 when B∗44:02 and A80 antibodies were detected by SAB. Serum from Mar ‘12 was negative for HLA Class I, II, and MICA by SAB. Quarterly sera from April ‘12 till Feb ‘13 had no HLA or MICA antibodies using LSM and or LabScreen ID and transplant was done from a DD in April’13 based on negative T-B FC using mouse monoclonal antihuman-IgG FITC using Feb’13 serum. The recipient had suboptimal graft function. Retro crossmatches and antibody assays with Mar and April ‘13 sera showed B∗44:02 DSA and both sera were T-B FC positive using splenocytes from the DD and blood lymphocytes from surrogate donor with Goat Antihuman IgG FITC. Using beads coated with lymphocyte lysates from the DD and surrogate, both sera had Class I DSA. The patient was treated based on DSA but the creatinine level remained abnormal. A biopsy ruled out immune mediated rejection. The DSA persists and the creatinine remains abnormal. In comparison, a living donor transplant (LD) recipient with no DSA, negative FC at the time of transplant, developed an A2, B∗44:03, DR7 and DR15 (recall DSAs) 7 days post transplant and suffered a C4d positive AMR. Conclusions The suboptimal graft function remains unclear in the DD case. The DSA assay with cell lysates might be useful to assess “actual DSA”. Both DD and LD cases show relevance of historic antibodies. The DD case needs follow-up to understand if alloimmunity is associated with the observed sub-optimal graft function.
How to Interact with Media and Speak in Public

Physicians have a social obligation to heal, discover, and teach. Our educational mission extends beyond our role in professional endeavors and mandates that we inform the public about health-related matters. A major vehicle for this is through our interactions with media. As physicians, we may be contacted by journalists to discuss medical problems and treatment, new research findings, health-related matters in the news, or positions on health policy. Few of us have been trained to talk with the media. To effectively engage with the media, we need to understand the motivation and function of journalists, the various types of media in which we may choose to engage, and appreciate that the skills required to be effective, ethical, and professional require acquiring new skills and practice. While there are many potential pitfalls in this endeavor, media presents us with an ability to reach a very broad audience and provide education that may further public health.
Incidence of and risk factors for postoperative urinary retention in men after carotid endarterectomy

Abstract Objective The goal of this study was to determine the incidence of postoperative urinary retention (POUR) in men after carotid endarterectomy (CEA) and to identify preventable risk factors for the development of this complication. Methods All male patients who underwent CEA from 2014 to June 2018 were identified. Exclusions included CEA with concomitant cardiac surgery, baseline dialysis, and indwelling or straight catheterization. POUR was the primary end point, defined as inability to void requiring catheterization within 24 hours postoperatively or after removal of a preoperatively placed Foley catheter. POUR was further classified as mild (single catheterization), moderate (multiple catheterizations), or severe (catheterization prolonging discharge or discharge with catheter). Logistic regression assessed for POUR risk factors. Results There were 294 male patients who underwent CEA during the study period; 82 (28.2%) developed POUR. Of these, 48 (57.8%) were mild, 15 (18.1%) were moderate, and 20 (24.1%) were severe. At baseline, POUR was associated with older age, peripheral artery disease (PAD), chronic kidney disease, diabetes, ambulation deficit, prior urinary retention, and statin and chronic tamsulosin use. Overall, 31.6% (93) of the cohort had a Foley catheter placed before the procedure, and this was protective against POUR (no Foley vs Foley, 31.8% vs 20.4%; P = .043). Independent risk factors for POUR included prior urinary retention (odds ratio [OR], 3.4 [1.6-7.3]; P = .002), diabetes (OR, 2.1 [1.1-3.7]; P = .016), PAD (OR, 2.3 [1.1-5.2]; P = .036), and age (per year: OR, 1.1 [1.02-1.10]; P Conclusions POUR is common in men undergoing CEA, and almost a quarter of those with POUR have a discharge delay or are discharged with a Foley catheter. Preoperative Foley catheterization is protective against POUR and should be considered in older patients, diabetics, patients with PAD, and those with a history of urinary retention.
Time Dependence of Few-Body Förster Interactions among Ultracold Rydberg Atoms

Rubidium Rydberg atoms in either $|{m}_{j}|$ sublevel of the $36{p}_{3/2}$ state can exchange energy via Stark-tuned F\"orster resonances, including two-, three-, and four-body dipole-dipole interactions. Three-body interactions of this type were first reported and categorized by Faoro et al. [Nat. Commun. 6, 8173 (2015)] and their Borromean nature was confirmed by Tretyakov et al. [Phys. Rev. Lett. 119, 173402 (2017)]. We report the time dependence of the $N$-body F\"orster resonance $N\ifmmode\times\else\texttimes\fi{}36{p}_{3/2,|{m}_{j}|=1/2}\ensuremath{\rightarrow}36{s}_{1/2}+\phantom{\rule{0ex}{0ex}}37{s}_{1/2}+(N\ensuremath{-}2)\ifmmode\times\else\texttimes\fi{}36{p}_{3/2,|{m}_{j}|=3/2}$, for $N=2$, 3, and 4, by measuring the fraction of initially excited atoms that end up in the $37{s}_{1/2}$ state as a function of time. The essential features of these interactions are captured in an analytical model that includes only the many-body matrix elements and neighboring atom distribution. A more sophisticated simulation reveals the importance of beyond-nearest-neighbor interactions and of always-resonant interactions.
Using Compression-Only CPR Mini-Training Sessions to Address Rural Bystander Care

Purpose: Rural populations face vast disparities in out-of-hospital cardiac arrest survival rates when compared with urban populations. Furthermore, rural areas have lower CPR training rates. Compression-Only CPR (COCPR) is a simplified resuscitation method that eliminates the task of rescue breathing. The simplified nature can significantly reduce training times and be more comprehendible and convenient for the general population. The purpose of this study is to assess the change in knowledge and self-confidence of rural college students to administer COCPR as a result of mini-training sessions. Sample: Purposive sampling was used to focus on the 125 rural college students who received a COCPR mini-training session at the medium sized University located in a rural state with a historically low CPR training rate. Method: Each participant completed a 14 question pre-survey, the COCPR training, and 13 question post-survey. Descriptive statistics on the pre-, post-, and subscale change scores for both knowledge and self-confidence were computed and one-way between subjects ANOVAs were conducted to determine differences between group means related to prior CPR training. Findings: The training resulted in a positive increase in the participants’ knowledge and confidence to administer care. Furthermore, the participants indicated that they would recommend this training to others. Conclusions: This study provides insight into the viability of providing COCPR in lieu of conventional CPR, supports having individuals trained at an earlier age to provide bystander care, and supports training individuals in rural areas where response time is delayed. DOI: http://dx.doi.org/10.14574/ojrnhc.v20i1.593 Keywords: Rural, Bystanders, CPR, Compression Only, Cardiopulmonary Resuscitation, Cardiac Arrests
Molecular details of protein condensates probed by microsecond-long atomistic simulations

Abstract The formation of membraneless organelles in cells commonly occurs via liquid-liquid phase separation (LLPS), and is in many cases driven by multivalent interactions between intrinsically disordered proteins (IDPs). Molecular simulations can reveal the specific amino acid interactions driving LLPS, which is hard to obtain from experiment. Coarse-grained simulations have been used to directly observe the sequence determinants of phase separation but have limited spatial resolution, while all-atom simulations have yet to be applied to LLPS due to the challenges of large system sizes and long time scales relevant to phase separation. We present a novel multiscale computational framework by obtaining initial molecular configurations of a condensed protein-rich phase from equilibrium coarse-grained simulations, and back mapping to an all-atom representation. Using the specialized Anton 2 supercomputer, we resolve microscopic structural and dynamical details of protein condensates through microsecond-scale all-atom explicit-solvent simulations. We have studied two IDPs which phase separate in vitro: the low complexity domain of FUS and the N-terminal disordered domain of LAF-1. Using this approach, we explain the partitioning of ions between phases with low and high protein density, demonstrate that the proteins are remarkably dynamic within the condensed phase, identify the key residue-residue interaction modes stabilizing the dense phase, all while showing good agreement with experimental observations. Our approach is generally applicable to all-atom studies of other single and multi-component systems of proteins and nucleic acids involved in the formation of membraneless organelles.
Misbehaving Toddler or Moody Teenager: Examining the Maturity of the Field of K-12 Online Learning

espanolDependiendo de la referencia, la practica del aprendizaje en linea de K-12 comenzo en algun momento entre 1991 y 1996. Sin embargo, casi tres decadas despues, todavia hay poca investigacion para describir la experiencia de los estudiantes de aprendizaje en linea de K- 12, que ha resultado en una falta de comprension del modelo de instruccion real, la naturaleza del plan de estudios y el tipo y la cantidad de apoyo empleado por los programas de aprendizaje en linea K-12. Ademas, gran parte de la investigacion disponible es teorica, metodologicamente cuestionable, contextualmente limitada y sobregeneralizada. Todos estos factores hacen que la investigacion de aprendizaje en linea K-12 que existe sea de poco valor para guiar la practica. Este manuscrito examina la madurez de la investigacion en el campo del aprendizaje en linea en K-12, con el objetivo de proporcionar a los investigadores un impacto significativo en la practica futura. EnglishDepending on the reference, the practice of K-12 online learning began sometime between 1991 and 1996. Yet two and a half to three decades later, there is still little research to describe the K-12 online or blended learning student experience, which has resulted in a lack of understanding of the actual instructional model, nature of the curriculum, and type and amount of support employed by K-12 distance, online, and blended learning programs. Further, much of the available research is atheoretical, methodologically questionable, contextually limited, and overgeneralized. All these factors make the K-12 distance, online, and blended learning research that does exist of little value in guiding practice. This manuscript examines the maturity of research in the field of K-12 distance, online, and blended learning, with the goal of providing researchers with meaningful impact on future practice.
Designing Training Scenarios for Stressful Spaceflight Emergency Procedures

Graduated stress exposure aims to alleviate the negative effects of stress on task performance during high-stress conditions. Skills are practiced in increasing stress conditions that approximate the operational environment. Practice continues until stress resilience and task proficiency are achieved. The use of virtual reality (VR) for inducing a stress response has increased in popularity in recent years. The ability to simulate operational tasks could create training based on graduated stress exposure. However, more research is needed to verify that stress levels can be effectively manipulated in the virtual environment during training, and that the VR training task accurately replicates the existing task procedure. The objective of this study was to investigate the creation of different VR stressor levels from existing emergency spaceflight procedures and validate three distinguishable stressor levels (i.e., low, medium, high). Experts in spaceflight procedures and the human stress response helped design a VR spaceflight environment and emergency fire task procedure. A within-subject experiment was conducted using the three stressor levels. Sixty-one healthy participants completed three trials in VR to locate and extinguish a fire on the International Space Station (VR-ISS). Self-assessment was implemented for each stressor level; NASA Task load index, Post Task Stress Reaction scale, Free stress scale, Positive and Negative Affect Scale, and Short Stress State Questionnaire were used for assessment. The results suggest that the stressors can induce different, distinguishable, levels of stress in trainees for use in graduated stress exposure training.
Neighborhood Social Cohesion, Physical Disorder, and Daily Activity Limitations Among Community-Dwelling Older Adults.

Abstract Introduction Although extensive factors have been examined for limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL), it remains unclear as to the impacts of neighborhood-level factors on ADL and IADL limitations. Thus, we aim to examine whether neighborhood characteristics are predictive of limitations in ADL and IADL. Methods A total of 7,407 participants were selected from the National Health and Aging Trend Study. We used data from round 1 (2011) to round 8 (2018). Neighborhood characteristics were measured as social cohesion and physical disorder. Daily activity limitations were counted based on the domains of ADL and IADL. Mixed-effects negative binomial regression analyses were performed to estimate the effects of neighborhood features on ADL and IADL limitations. Results Better neighborhood social cohesion significantly predicted less limitations in ADL (incidence rate ratio [IRR] = 0.98, 95% confidence interval [CI] = 0.96 - 0.99) and IADL (IRR=0.96, 95% CI = 0.95 - 0.98). More physical disorder predicted more IADL limitations (IRR=1.04, 95% CI = 1.01 - 1.06), but was not associated with ADL limitations. Conclusion Neighborhood social cohesion is essential in enabling older adults to perform both basic self-care activities and more complex tasks, while neighborhood physical disorder is significant to older adults’ capability in performing more complex sets of activities so as to age in place. The study findings underscore the importance of improving both social and physical aspects of neighborhood environment to facilitate older adults’ daily activity performance.
Management Strategies to Promote Follow-Up Care for Incidental Findings: A Scoping Review

Abstract Background Incidentalomas, or unexpectedly identified masses, are frequently identified in diagnostic imaging studies. Incidentalomas may require timely follow-up care to determine if they are benign, disease-causing, or malignant lesions; however, many incidentalomas do not receive diagnostic workup. The most effective strategies to manage incidentalomas and optimal metrics for judging the efficacy of these strategies remain unclear. Objective To identify management strategies used to promote guideline-concordant follow-up for incidentalomas and commonly reported performance metrics associated with these strategies. Data sources We searched peer-reviewed literature for incidentaloma management studies published between 2003 and 2020. Data extraction and synthesis Data extraction included anatomical location, imaging modality, clinical setting, management strategy characteristics, and metrics used to assess the management strategy. Eligible studies were analyzed qualitatively to describe strategies and metrics. Results In all, 15 studies met inclusion criteria. Four types of interventions designed to promote guideline-concordant follow-up care for incidentalomas were identified: (1) physical or verbal guideline reminders (n = 3); (2) electronic guideline references (n = 4); (3) enhanced radiology templates (n = 3); (4) restructured clinical and communication pathways (n = 5). Strategy efficacy was assessed by measuring rates of patients who received recommended follow-up care (n = 6) or had care recommendations documented in clinical records (n = 5). Few studies measured diagnostic outcomes associated with incidentalomas. Conclusions Most management strategies target changes in radiologists’ behavior. Few studies address barriers to improving incidentaloma follow-up from interpretation to patient education of findings and care delivery. Hybrid effectiveness-implementation studies are needed to better address workflow barriers and rigorously evaluate care delivery outcomes.
Watershed studies at the Hubbard Brook Experimental Forest: Building on a long legacy of research with new approaches and sources of data

The Hubbard Brook Experimental Forest (HBEF) was established in 1955 by the U.S. Department of Agriculture, Forest Service out of concerns about the effects of logging increasing flooding and erosion. To address this issue, within the HBEF hydrological and micrometeorological monitoring was initiated in small watersheds designated for harvesting experiments. The Hubbard Brook Ecosystem Study (HBES) originated in 1963, with the idea of using the small watershed approach to study element fluxes and cycling and the response of forest ecosystems to disturbances, such as forest management practices and air pollution. Early evidence of acid rain was documented at the HBEF and research by scientists at the site helped shape acid rain mitigation policies. New lines of investigation at the HBEF have built on the long legacy of watershed research resulting in a shift from comparing inputs and outputs and quantifying pools and fluxes to a more mechanistic understanding of ecosystem processes within watersheds. For example, hydropedological studies have shed light on linkages between hydrologic flow paths and soil development that provide valuable perspective for managing forests and understanding stream water quality. New high frequency in situ stream chemistry sensors are providing insights about extreme events and diurnal patterns that were indiscernible with traditional weekly sampling. Additionally, tools are being developed for visual and auditory data exploration and discovery by a broad audience. Given the unprecedented environmental change that is occurring, data from the small watersheds at the HBEF are more relevant now than ever and will continue to serve as a basis for sound environmental decision-making.
Risk factors for chronic kidney disease following acute kidney injury in pediatric allogeneic hematopoietic cell transplantation.

Risk factors associated with the progression of acute kidney injury to chronic kidney disease in pediatric allogeneic hematopoietic cell transplantation (AlloHCT) recipients are not well described. We retrospectively investigated the risk factors for the progression to CKD in 275 AlloHCT recipients. AKI and CKD grading was defined according to the Kidney Disease Improving Global Outcomes classification. PRI90 was defined as persistent renal insufficiency (estimated GFR < 90 ml/min/1.73 m2) 90 days after the first episode of AKI. The median age was 9.1 years. Incidence of stages 1, 2, and 3 AKI were 43%, 41%, and 15%, respectively. 86.1% met our study criteria for PRI90. Of the 236 PRI90 patients, 213 and 152 patients were evaluable for CKD at 1 and 3 years, respectively. The incidence of CKD at 1 and 3 years was 63.1% and 62.9%, respectively. On multivariable analysis, estimated GFR at initial episode of AKI (<80 ml/min/1.73 m2) and estimated GFR (<70 ml/min/1.73 m2) at PRI90 was a risk factor associated with CKD development and both risk factors were associated with significantly lower overall survival. To conclude, eGFR at the time of AKI and PRI90 may be considered for screening pediatric AlloHCT recipients at risk for the progression to CKD.
Association between metabolic syndrome and resting-state functional brain connectivity

The objective of this study is to examine whether metabolic syndrome (MetS), the clustering of 3 or more cardiovascular risk factors, disrupts the resting-state functional connectivity (FC) of the large-scale cortical brain networks. Resting-state functional magnetic resonance imaging data were collected from seventy-eight middle-aged and older adults living with and without MetS (27 MetS; 51 non-MetS). FC maps were derived from the time series of intrinsic activity in the large-scale brain networks by correlating the spatially averaged time series with all brain voxels using a whole-brain seed-based FC approach. Participants with MetS showed hyperconnectivity across the core brain regions with evidence of loss of modularity when compared with non-MetS individuals. Furthermore, patterns of higher between-network MetS-related effects were observed across most of the seed regions in both right and left hemispheres. These findings indicate that MetS is associated with altered intrinsic communication across core neural networks and disrupted between-network connections across the brain due to the co-occurring vascular risk factors in MetS.