cssi/SciSciGPT-SciSciNet huggingface dataset:
Müller’s Muscle-Conjunctiva Resection

The Muller’s muscle-conjunctiva resection ptosis procedure is recommended for patients with blepharoptosis whose upper eyelids elevate to a normal level when 10% phenylephrine drops are applied to the upper ocular fornix. Candidates usually have minimal congenital ptosis and varying degrees of acquired ptosis. The advantage over the Fasanella procedure is that Muller’s muscle-conjunctiva resection preserves the tarsus, and the advantage over the levator aponeurosis procedure is that it produces predictable results.
Leadership Responses to Institutional Change in Japan

Paper prepared for delivery at The American Political Science Association Annual Meeting in Toronto, Canada, September 3-6, 2009. Panel Title: Leadership and Policy Change in the Era of Complexity.In 1994 Japan instituted an electoral and campaign finance reform that changed its electoral system from SNTV to MMM, and in 2001 instituted an administrative reform that provided more authoritative influence in the cabinet to the prime minister, among other changes. There have now been five elections under the new electoral system, enough time to assess how political leadership in Japan responded to these changes and what constituted successful techniques and strategies of political leadership to accomplish policy change before and after institutional reform. This paper will compare the two most successful examples of prime ministerial 'entrepreneurial initiation' leadership under the ruling Liberal Democratic Party from 1955-2009. First, Prime Minister Nakasone (1982-1987) prior to the post-1994 reforms, succeeded in passing an administrative reform that privatized major public corporations in the face of resistance from bureaucrats, the public corporations and labor unions. Second, Prime Minister Koizumi (2001-2006) after the reforms accomplished a major postal system (including the massive postal savings program) privatization over the rebellion and opposition of several key members of his own party. We then will analyze the techniques of leadership used by Nakasone and Koizumi, why they succeeded when those of the other prime ministers in the same institutional context failed to accomplish reform, and how these varied in the different institutional contexts in which they operated. We find that the key common heresthetic techniques were manipulating issue dimensions, managing their media strategy and image, issue framing, and ability to understand how to manipulate the institutional capabilities and political context of their office at the time, among other factors. Koizumi’s techniques, however, had the potential to be more systemically transformative than Nakasone’s: using the new capabilities of institutional reform his leadership bode to change the entire policymaking process and nature of his party. This potential was totally dissipated by his unskillful successors, and the LDP lost power in the August 30 2009 election.
AB INITIO MOLECULAR ORBITAL CALCULATIONS OF THIRD-ORDER HYPERPOLARIZABILITIES OF ORGANIC MOLECULES

Ab initio molecular orbital calculations of third-order hyperpolarizabilities γ have been carried out for organic molecules containing hetero atoms. Basis set dependence of the calculated γ values has been investigated extensively. It was found that the 6–31G basis set augmented with the diffuse p and d functions shows order-of-magnitude agreements with the observed γ values.
Efficient VTS Adaptation Using Jacobian Approximation.

By exploiting a model of environmental distortion, model adaptation based on vector Taylor series (VTS) approaches have been shown to significantly improve the robustness of speech recognizers to environmental noise. However, the computational cost of VTS model adaptation (MVTS) methods hinders them from being more widely used. In this paper, we propose to reduce the computational cost of MVTS by replacing the Jacobian matrix used in the vector Taylor series approximation with a diagonal Jacobian matrix (DJVTS). We verify this approximation by showing that the Jacobian matrices are dominated by their diagonal elements and therefore the model distortion introduced by this approximation is very small. DJVTS gives similar accuracy as the standard MVTS method with significant reduction in computational cost. The proposed method also achieves higher accuracy than VTS-based feature enhancement.
Posterior fossa dural arteriovenous fistula with isolated sinus segment

Radiological and clinical analysis was performed in 5 patients with posterior fossa dural arteriovenous fistulas (DAVFs) with isolated sinus segment due to sinus thrombosis, and their patho physiological, diagnostic, and therapeutic concerns were discussed. Patients ranged in age from 36 to 73 years old with a mean of 57 years and included 2 males and 3 females. Two patients presented with ataxia, one with ataxia and bruit, one with atypical facial pain, and one with parietal dysfunction. One patient had a history of hemorrhagic event. DAVFs were located at transverse-sigmoid sinus (3 cases), superior petrosal sinus (1 case), and straight sinus (1 case). They were fed by many branches of external carotid artery including middle meningeal artery, ascending pharyngeal artery, posterior auricular artery, occipital artery, meningeal branches of vertebral artery and posterior cerebral artery, and meningohypophyseal trunk of internal carotid artery. Shunt flow drained into contralateral transverse-sigmoid or supratentorial sinuses via the isolated venous segment through markedly dilated cortical and/or deep venous systems, which caused altered normal venous drainage pattern and venous hypertension. Transarterial embolization in multiple stages (mean 3.4) using n-butyl cyanoacrylate (NBCA) could alleviate symptoms in all cases. DAVFs were almost totally obliterated in 3 patients. Further embolization in one case, and surgical excision in one case were planed because of some residual dilated cortical venous drainage. Posterior fossa DAVFs with isolated sinus segment accompany markedly dilated cortical and/or deep venous systems. They could cause cerebellar, brainstem, or cranial nerve dysfunctions, and sometimes present distant supratentorial symptoms or hydrocephalus due to abnormal venous drainage and venous hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
A 60-Year-Old Woman with Skin Thickening, Joint Contractures, and Peripheral Blood Eosinophilia

Eosinophilic fasciitis (EF), also termed diffuse fasciitis with eosinophilia (DFE), is a disorder in the spectrum of skin fibrosing diseases characterized by woody induration of the skin involving the extremities, classically sparing the hands and feet. Patients with EF typically lack the visceral and autoimmune features characteristic of systemic sclerosis (SSc); specifically, EF patients do not typically manifest Raynaud’s phenomenon, gastroesophageal reflux, parenchymal lung or kidney disease, serologic abnormalities, for example, ANA or anti-topoisomerase I antibody, or abnormal nailfold capillary morphology. The skin involvement in EF can cause discomfort as well as be associated with joint contractures. Unlike SSc, EF patients generally respond well to glucocorticoid treatment. High-dose glucocorticoid therapy can provide substantial improvement or even resolution of the skin induration and thickening. Physical therapy is another key component in the management of patients with EF in order to avoid reduced function associated with joint flexion contractures. Immunosuppressive medications have also been used to treat patients with EF with mixed results.
Buffered, phosphate-containing media suitable for aluminum toxicity studies

Studies of Al rhizotoxicity sometimes require the use of well-defined rooting media. For that reason, buffers and phosphate are often omitted from Al solutions for which species composition must be determined precisely. Homopipes and succinate appear to be suitable buffers for short-term studies with seedlings of an Al-sensitive wheat (Triticum aestivum L. cv. Scout 66) and white clover (Trifoliau repens L. cv. Huia). In the case of homopipes (homopiperazine-N,N′-bis-2-[ethane-sulfonic acid]), a slight inhibition of root elongation must be taken into account, but no binding of Al3+ was observed. In the case of succinate, no inhibition of root elongation was observed, but Al3+ binding must be considered. Phosphate-containing media remain free of solid-phase or polynuclear species whenever {Al3+}2{HPO4 2-}{OH−}3 < 10−47.0 (or {Al3+}{HPO4 2-}{OH−}< 10−22.7) and when {Al3+}3 / {H+}3 < 108.8. These ion activity products, that define stable Al solutions in the laboratory, appear to apply in soils also, according to an analysis of published data. The published equilibrium values {AlH2PO4 2+} / ({Al3+}{H2PO4 −}) = 103.0, {AlHPO4 +} / ({Al3+}{HPO4 2-}) = 107.0, and {Alsuccinate+} / ({Al3+}{succinate 2-}) = 104.62 appear to be suitable, because solution toxicity could be accounted for entirely on the basis of computed Al3+ even in solutions containing high levels of Alsuccinate+ and AlHPO4 + (in every case {AlHPO4 +}>> {AlH2PO4 2+}). Thus, AlHPO4 + and Alsuccinate+ were not toxic at achieved concentrations.
Towards a Wider Perspective: Opening a Philosophical Space in the Mathematics Curriculum

The chapter argues that philosophical inquiry may have a place in the math classroom, helping to facilitate understandings that serve to complement and critically judge the inferences acquired in and with mathematics. In other words, philosophical inquiry may aid in the opening of a “wider horizon of interpretations” that includes a critical dimension. Such an opening represents a potential expansion of students’ mathematical experience, and promises to provide bridges for establishing richer, critical, and more meaningful connections and interactions between students’ personal experience and the broader culture.
Tick Microbiome Characterization by Next-Generation 16S rRNA Amplicon Sequencing

In recent decades, vector-borne diseases have re-emerged and expanded at alarming rates, causing considerable morbidity and mortality worldwide. Effective and widely available vaccines are lacking for a majority of these diseases, necessitating the development of novel disease mitigation strategies. To this end, a promising avenue of disease control involves targeting the vector microbiome, the community of microbes inhabiting the vector. The vector microbiome plays a pivotal role in pathogen dynamics, and manipulations of the microbiome have led to reduced vector abundance or pathogen transmission for a handful of vector-borne diseases. However, translating these findings into disease control applications requires a thorough understanding of vector microbial ecology, historically limited by insufficient technology in this field. The advent of next-generation sequencing approaches has enabled rapid, highly parallel sequencing of diverse microbial communities. Targeting the highly-conserved 16S rRNA gene has facilitated characterizations of microbes present within vectors under varying ecological and experimental conditions. This technique involves amplification of the 16S rRNA gene, sample barcoding via PCR, loading samples onto a flow cell for sequencing, and bioinformatics approaches to match sequence data with phylogenetic information. Species or genus-level identification for a high number of replicates can typically be achieved through this approach, thus circumventing challenges of low detection, resolution, and output from traditional culturing, microscopy, or histological staining techniques. Therefore, this method is well-suited for characterizing vector microbes under diverse conditions but cannot currently provide information on microbial function, location within the vector, or response to antibiotic treatment. Overall, 16S next-generation sequencing is a powerful technique for better understanding the identity and role of vector microbes in disease dynamics.
Policy design to support cross-boundary land management: The example of the Joint Chiefs Landscape Restoration Partnership

Abstract There is a mismatch between large-scale, dynamic, ecological processes and the scales at which individual land management agency units have the capacity and authority to work. To improve environmental governance, scholars across disciplines emphasize the need to work across jurisdictional and organizational boundaries to support collective action and address scale mismatches. An important question now is how to design policies that support collaborative management across jurisdictional boundaries to produce improved outcomes. Our research evaluated the Joint Chiefs Landscape Restoration Partnership, a new policy tool in use by the US federal government to support forest restoration activities across the public-private divide, to investigate two research questions: 1) Did the policy design of the Joint Chiefs Partnership effectively support cross-boundary work? And, 2) What underlying conditions helped or hindered the ability of project participants to undertake cross-boundary work using this policy approach? To glean program-wide understanding of the Joint Chiefs Partnership, we conducted 62 semi-structured interviews with agency staff and external participants in the program. We found that the requirement to collaborate and infusion of committed, multi-year funding supported faster implementation of planned work and increased coordination across jurisdictions and partners. Previously established collaborative relationships were reported as the most critical factor underlying success, while limited agency capacity was reported as significantly impeding project success. Our findings suggest that this policy tool, which incorporates proposed policy design principles to support improved governance, was successful for supporting cross-boundary management and collective action. The results from this study also raise practical questions about tradeoffs under programs that prioritize funding investments and about navigating among the variables that affect policy implementation. Our study contributes to the broader literature on policy design for complex environmental governance challenges and provides an empirical evalution of a policy tool in a specific legal, administrative, and land management context.
Paleothermometry and distribution of calcite beef in the Vaca Muerta Formation, Neuquén Basin, Argentina

The term “beef” describes bedding-parallel calcite veins found commonly in the organic-rich matrix of unconventional resource plays. Although some authors have interpreted beef to be an early diagenetic feature, these calcite veins are commonly attributed to precipitation at high temperatures and localized overpressure during hydrocarbon generation. The temperature at which the beef formed is thus crucial to ascertain the process of beef genesis. We use the novel methodology of clumped isotope analysis to constrain both the temperature at which beef forms and the isotopic composition of fluids present during formation. For this study, we use beef from basinal sections of the Vaca Muerta Formation in the Neuquen Basin, where veins are commonly up to approximately 10 cm (∼4 in.) thick and are laterally continuous over 1 km (0.6 mi). The calcite veins occur in isolation or in association with concretions and ash layers. Sequence stratigraphic boundaries have little influence on distribution, and only a low correlation between beef and total organic content or beef and ash layers exists. The internal crystal structure of beef varies largely, suggesting both syntaxial and antitaxial growth forms. The δ18O values of beef range from approximately −12‰ to −9‰, and the δ13C values vary between approximately −1‰ and 1‰. The surrounding mudstone and concretion fracture fills (calcite) show little difference isotopically when compared to the beef itself. The δ18O values of nearby concretions range from approximately −3.5‰ to 1‰, and the δ13C values vary between approximately 6‰ and 11‰. Clumped isotope analysis of beef in the Vaca Muerta Formation indicates temperatures between approximately 140°C and 195°C, whereas the surrounding mudstones vary from approximately 120°C to 150°C. The corresponding formation fluid δ18Ow values range from 8.5 to 14.5‰. These temperature data are higher than the maximum temperatures suggested by published studies modeling the basin’s thermal and burial histories. If these models are correct, the clumped isotope data indicate that the growth of beef in the Vaca Muerta Formation required the input of hydrothermal fluids from greater depths. Alternatively, the geothermal gradient or burial depth was underestimated in these models.
Biliary tract cancer incidence and trends in the United States by demographic group, 1999-2013

BACKGROUND Biliary tract cancers (BTCs) are rare but deadly cancers (gallbladder cancer [GBC], intrahepatic cholangiocarcinoma [ICC], extrahepatic cholangiocarcinoma [ECC], and ampulla of Vater cancer [AVC]). A recent US study reported increasing GBC incidence among people younger than 45 years and blacks; however, it did not examine trends for other biliary tract sites. METHODS This study characterized demographic differences in BTC incidence rates and time trends by anatomic site. Population-based North American Association of Central Cancer Registries data were used to calculate age-adjusted incidence rates, incidence rate ratios (IRRs), and estimated annual percent changes (eAPCs) for 1999-2013 by site and demographic group. For sites with significant differences in eAPC by age group, IRRs were compared by age group. RESULTS GBC incidence rates declined among women (eAPC, -0.5%/y; P = .01) and all racial/ethnic groups except for non-Hispanic blacks, among whom rates increased (1.8%/y; P < .0001). Although GBC rates increased among 18- to 44-year-olds (eAPC, 1.8%/y; P = .01), they decreased among people 45 years old or older (-0.4%/y; P = .009). Sex (P < .0001) and racial/ethnic differences (P = .003 to .02) in GBC incidence were larger for younger people than older people. During this period, ICC (eAPC, 3.2%/y; P < .0001) and ECC rates (1.8%/y; P = .001) steadily increased across sex and racial/ethnic groups. Although AVC incidence rates increased among younger adults (eAPC, 1.8%/y; P = .03) but not older adults (-0.20%/y; P = .30), sex and racial/ethnic IRRs did not differ by age. CONCLUSIONS Differential patterns of BTC rates and temporal trends have been identified by anatomic site and demographic groups. These findings highlight the need for large pooling projects to evaluate BTC risk factors by anatomic site.
Nanotechnology: Managing Molecules for Modern Medicine

Although “nanotechnology” simply means technology at the scale of the nanometer (nm) – one billionth (10−9) of a meter – implementation of the concept of constructing materials molecule by molecule or atom by atom can be quite challenging. Yet increasingly we realize that the functions of the human body in both health and disease require analyses at the nano-level for true understanding. Bacteria, viruses, and DNA are tens of nanometers in size; red blood cells, neurons, and the smallest blood vessels (capillaries) are tens of microns (one micron = 1000 nanometers) in size. Obviously the instruments used in hospitals for medical diagnosis and treatment depend on computer technologies engineered at the nano-level; in this chapter, several nano-level materials and techniques are considered to provide some insight into the breadth of nanotechnology involved in several aspects of modern medical diagnosis and treatment: 1. Nanotechnologies for inexpensive point-of-care (POC) testing 2. Wearable devices for real-time continuous diagnosis and therapy, as well as energy harvesting 3. Nanoparticles to enhance the effectiveness of radiation therapy (RT) 4. Nanotechnology to enhance the brain-machine interface (BMI) for precision monitoring and modulating of brain electrochemical activity
Anion formation by neutral resonant ionization

Abstract A collision–radiation model of the cesium plasma that forms within a pitted or recessed sample in a Middleton-type sputter ion source showed that excited states of Cs formed. These excited states of neutral Cs undergo resonant electron transfer with neutral sputtered atoms of AMS samples to produce the accelerated anions. Numerous reported effects from over 30 years are readily explained by this mechanism, including several that puzzled Middleton.
Die Bedeutung der Europawahl 2009 für die CSU

Das Jahr 2009 war in vielerlei Hinsicht ein besonderes fur die Christlich-Soziale Union. Zum einen war es das Jahr Eins nach der Landtagswahl 2008 und dem raschen Ende der Ara Beckstein/Huber. Zum anderen fanden in diesem „Super-Wahljahr“ sowohl die Wahl zum Europaischen Parlament als auch zum Deutschen Bundestag statt. Fur die CSU bedeutete dies eine besondere Herausforderung. Es galt, so schnell wie moglich die Landtagswahl 2008 vergessen zu machen, auf europaischer Ebene eine starke Vertretung zu bewahren und auch den Einfluss in Berlin nicht zu verlieren. Die Europawahl im Juni 2009 stellte dabei einen ersten Testlauf fur die neu aufgestellte CSU unter Ministerprasident Horst Seehofer dar. Wenige Monate vor der Bundestagswahl war dessen ausgemachtes Ziel, die Stimmverluste des vergangenen Jahres zu uberwinden und zu alter Starke zuruckzufinden.
PERCUTANEOUS CORONARY INTERVENTION IN NATIVE CORONARY ARTERIES VERSUS BYPASS GRAFTS IN PATIENTS WITH PRIOR CORONARY ARTERY BYPASS GRAFT SURGERY: INSIGHTS FROM THE VETERANS AFFAIRS CLINICAL ASSESMENT REPORTING AND TRACKING PROGRAM

Patients with prior coronary artery bypass graft (CABG) surgery often undergo percutaneous coronary intervention (PCI), yet the association between PCI target vessel on short- and long-term outcomes has received limited study. We sought to examine the frequency, associations and outcomes of native
Inside-Out: Beyond the Internal/External Distinction in Legal Scholarship

Ever since H.L.A. Hart introduced the concept of the “internal point of view” in the The Concept of Law (1961), the temptation to distinguish sharply between two “perspectives” on law – one internal, the other, external – has proven irresistible to legal scholars of various kinds. In the 1980s, Ronald Dworkin attacked the substance and the method of Hart’s philosophy of law but followed Hart in emphasizing the importance of an “internal point of view,” though he used the term in a slightly different way than had Hart. Since then, various versions of an internal/external distinction – whether as applied to points of view, attitudes, explanations, or forms of scholarship – have proliferated throughout the landscape of legal theory. One finds it popping up in debates within substantive areas of law, including tort law, criminal law, and constitutional law, as well as in methodological disputes over how to properly study judicial behavior or how to understand the relationship between law and other academic disciplines. The current popularity of the distinction prompts a number of questions. First and most obviously, why is it so popular? The distinction seems like a natural one to draw, but it is of relatively recent origin, so why did it catch on when it did? Second, given the diversity of uses to which it has been put, is there only one distinction, or do several go under the same name? If there are many distinctions, do they have anything in common? Finally, what function does the distinction (or distinctions) serve? Is that function a useful one for legal theory and practice? This article offers some answers to these questions. It begins by tracing the distinction back to its roots in the jurisprudential writings of H.L.A. Hart and Ronald Dworkin. There one finds three distinct understandings of an “internal point of view,” each with its own contrasting “external” perspective (or perspectives). The article then shows how subsequent scholars have broadened and modified each of these versions of the distinction and made use of them in different doctrinal and methodological debates. It then argues that all versions of the distinction, but particularly the two methodological versions of it, function to stifle scholarly debate, rather than to stimulate it, and to obscure important questions rather than to clarify them. The article concludes by suggesting that even if the distinction once served a useful role in legal theory, it no longer does and should therefore be retired.
Comparative Accuracy and Efficiency of Four Delirium Screening Protocols.

Background/objectives Systematic screening can improve detection of delirium, but lack of time is often cited as why such screening is not performed. We investigated the time required to implement four screening protocols that use the Ultra-Brief two-item screener for delirium (UB-2) and the 3-Minute Diagnostic Interview for Confusion Assessment Method (CAM)-defined Delirium (3D-CAM), with and without a skip pattern that can further shorten the assessment. Our objective was to compare the sensitivity, specificity, and time required to complete four protocols: (1) full 3D-CAM on all patients, (2) 3D-CAM with skip on all patients, (3) UB-2, followed by the full 3D-CAM in "positives," and (4) UB-2, followed by the 3D-CAM with skip in "positives." Design Comparative efficiency simulation study using secondary data. Setting Two studies (3D-CAM and Researching Efficient Approaches to Delirium Identification (READI)) conducted at a large academic medical center (3D-CAM and READI) and a small community hospital (READI only). Participants General medicine inpatients, aged 70 years and older (3D-CAM, n = 201; READI, n = 330). Measurements We used 3D-CAM data to simulate the items administered under each protocol and READI data to calculate median administration time per item. We calculated sensitivity, specificity, and total administration time for each of the four protocols. Results The 3D-CAM and READI samples had similar characteristics, and all four protocols had similar simulated sensitivity and specificity. Mean administration times were 3 minutes 13 seconds for 3D-CAM, 2 minutes 19 seconds for 3D-CAM with skip, 1 minute 52 seconds for UB-2 + 3D-CAM in positives, and 1 minute 14 seconds for UB-2 + 3D-CAM with skip in positives, which was 1 minute 59 seconds faster than the 3D-CAM (P Conclusion The UB-CAM, consisting of the UB-2, followed in positives by the 3D-CAM with skip pattern, is a time-efficient delirium screening protocol that holds promise for increasing systematic screening for delirium in hospitalized older adults.
Starting dose selection and dose escalation for oncology small molecule first-in-patient trials: learnings from a survey of FDA-approved drugs

The ideal starting dose for an oncology first-in-patient (FIP) trial should be low enough to be safe but not too far removed from therapeutically relevant doses. A low starting dose combined with small dose increments could lead to a lengthy dose escalation and could expose patients unnecessarily to sub-therapeutic dosing. In the current analyses, we reviewed 59 approved small molecule oncology drugs (SMOD) with the overarching goals to assess the current approaches of FIP starting dose selection and dose escalation, and to identify potential opportunities for improving trial efficiency and minimizing number of patients receiving sub-therapeutic dose levels. Of 59 SMODs, the majority (~ 66%) were kinase inhibitors and ~ 73% were approved for solid tumor indications. Most of the trials used a 3 + 3 design for dose escalation and had a median (range) of 4 cohorts (0–11) to reach MTD from the starting dose. The maximum tolerated dose (MTD) or recommended phase 2 dose (RP2D) to starting dose ratio was highly variable with a median (range) of 8 (0.25–125). About 71% of the FIP trials had < 6 dose escalation steps to reach MTD or RP2D (with 15% ≤ 2 dose escalations), but the remaining 29% of trials had ≥ 6 dose escalation steps to reach MTD or RP2D suggesting that there is still room for increasing efficiency by reducing the number of dose escalation steps, reducing the variability in MTD to starting dose ratio, and consequently reducing significant number of patients exposed at sub-therapeutic doses in the dose escalation phase of FIP study.
Care of Transgender Patients: Incontinence

Urinary incontinence in the transgender patient is a common quality of life issue. It is important to understand the impact and overall trends in this population, as well as considering options for treatment. Evaluation includes a thorough history as well as physical examination and determination of cause of incontinence. Treatment options must be individualized to the patient and specific source of incontinence.
A validated modification of the vaccine hesitancy scale for childhood, influenza and HPV vaccines.

INTRODUCTION Vaccine hesitancy contributes to outbreaks of preventable disease worldwide. The Vaccine Hesitancy Scale (VHS), developed by the international WHO SAGE Working Group, has been validated previously for measuring hesitancy towards childhood vaccines; some psychometric properties were suboptimal. METHODS We collected data using large, nationally-representative samples of parents in the U.S. We adapted the VHS items, and additional hesitancy items, to assess hesitancy towards influenza and HPV vaccines in addition to routine childhood vaccines. We then used exploratory and confirmatory factor analysis to identify latent constructs and create modified scales for childhood (VHS-child), influenza (VHS-flu) and HPV (VHS-HPV) vaccines with improved psychometric properties. Finally, we compared hesitancy scores on the VHS-child, VHS-flu, and VHS-HPV, to self-reported receipt of each vaccine category, and compared subscale scores to assess whether drivers of hesitancy differed by vaccine category. RESULTS 2052 parents of children <18 years old completed the VHS-child and VHS-flu while 2020 parents of adolescents completed the VHS-HPV. A two-factor structure of 'risks' and a 'lack of confidence' was found for each vaccine category. Slight modifications to the VHS improved psychometric properties. Hesitancy was strongly associated with vaccine receipt: e.g., 76% of parents not hesitant towards influenza vaccine had vaccinated their child the past season, versus 9% of hesitant parents (p < 0.0001). Subscale scores also differed significantly between vaccines: lack of confidence was greater towards influenza (Median (IQR): 2.0 (1.2, 3.3)) and HPV (2.0 (1.3, 3.0)) vaccines than childhood (1.2 (1.0, 1.8), p < 0.0001 for both) vaccines; perceived risks of HPV vaccines (2.7 (1.7, 3.7)) were greater than for childhood vaccines (2.0 (1.3, 3.0), p < 0.0001). CONCLUSIONS Our modified VHS scales perform well psychometrically and allow for consistent measurement of the extent and reasons for hesitancy between vaccine categories. We suggest that future work use these scales to examine hesitancy towards other vaccines and to monitor hesitancy over time.
Sustained response to lenvatinib and pembrolizumab in two patients with KRAS-mutated endometrial mesonephric-like adenocarcinoma

•Endometrial mesonephric-like adenocarcinoma (MLA) is a rare and aggressive subtype of epithelial endometrial cancer.•KRAS mutations are characteristic in patients with endometrial MLA.•We report two cases of KRAS-mutated endometrial MLA with excellent and durable responses to lenvatinib and pembrolizumab.•Tumors with KRAS mutations may be particularly sensitive to lenvatinib, but this warrants further study.
Prevalence of medical and nonmedical cannabis use among veterans in primary care.

Objective This study examined past-year cannabis use prevalence and sociodemographic and clinical correlates of cannabis use among Veterans Health Administration (VHA) primary care patients in a state with legalized medical cannabis. Method Participants were 1,072 predominantly white, male, VHA primary care patients enrolled in a drug screening validation study (2012-2014). Sociodemographic and clinical correlates were examined by past-year cannabis use status. Multivariate regression models, adjusted for demographics, estimated cannabis use prevalence and clinical correlates among recreational, medical, and both medical and recreational users. Results Nearly one in five (18.7%) veterans endorsed past-year cannabis use, with 14.1% of the total sample reporting any recreational use and 7.0% reporting any medical use. Correlates of any past-year use included younger age, period of service, being unmarried, lower education, lower income, other substance use, meeting criteria for an alcohol or drug use disorder or posttraumatic stress disorder, higher pain rating, and lower self-reported well-being. Compared to veterans endorsing only recreational use, veterans endorsing only medical use reported more cannabis use days but had lower odds of other drug use, alcohol or drug-related problems, or alcohol or drug use disorders. Differences between recreational only users and those using medical and recreational cannabis were minimal. Conclusions Veterans enrolled in VHA in states with legalized cannabis may be particularly likely to use cannabis. Veterans identifying as recreational users may be at increased risk for adverse clinical outcomes compared to medical-only users. Prevalence monitoring, assessment, and intervention services should be considered, particularly in states with legalized cannabis. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
'Direction and control' defined in guiding physician assistant

Detailed fetal intracranial anatomy can be examined in utero using real-time sonography. The ability to demonstrate motion makes it possible to visualize important vascular landmarks which are helpful in identifying adjacent structures and in recognizing appropriate planes of section. The lateral ventricular system can be demonstrated and the lateral ventricular ratio can be determined in cases beyond 27 weeks gestation if the head is in an occiput transverse position. A lateral ventricular ratio greater than 0.45 (bodies) or greater than 0.65 (atrium) should raise the question of hydrocephalus and close follow-up measurements of the biparietal diameter, the head circumference/abdominal circumference ratio, and the lateral ventricular system should be made to evaluate this possibility. The fetal third ventricle is not routinely visualized before 34 weeks gestation in the absence of hydrocephalus; alternative anatomic explantations for the structure commonly referred to in the literature as the fetal third ventricle are discussed.
Population Genetics of the t and H-2 Systems

A population is an assembly of individuals sharing a common gene pool, that is, the group of genes from which those of the next generation are chosen. Genetic constitution of a population is defined by the gene and genotype frequencies calculated from the corresponding phenotype frequencies. Phenotype (genotype, gene) frequencies are obtained by counting the individuals carrying the particular phenotype (genotype, gene) and dividing the sums by the number of individuals in the population. The frequencies are expressed as percentages (0–100 percent) or fractions, ranging from 0 to 1. All phenotype frequencies and the genotype frequencies for dominant genes are obtained by direct counting; genotype frequencies for recessive genes are computed using special statistical methods. Gene frequencies are calculated from genotype frequencies as illustrated by the following example. Take two genes, A1 and A2, and their frequencies, p and q, respectively, where p+q = 1. Consider three genotypes, A1A1, A1A2, and A2A2, and their respective frequencies P, H, and Q, where P+H+Q = 1. The relationship between gene and genotype frequencies is then expressed by the equations $$\begin{array}{*{20}{c}} {p = P + \tfrac{1}{2}H} \\ {q = Q + \tfrac{1}{2}H} \\ \end{array}$$
Superhydrophobic condenser surfaces for air gap membrane distillation

Superhydrophobic surfaces for enhanced condensation in air gap membrane distillation (AGMD) may provide significantly improved distillate production rates and increased thermal efficiency. While AGMD is one of the most thermally efficient membrane distillation desalination configurations, large transport resistances in the air gap limit distillate production rates. AGMD experiments were performed with combinations of untreated, hydrophobic, and superhydrophobic condensation surfaces. A nanostructured copper oxide coated condensing surface produced durable 164°±4° contact angles and jumping droplet condensation. Tests were also performed on the air gap spacer, in this case a small diameter support mesh, to judge the effects of superhydrophobic treatment and conductivity on distillate production for AGMD. A novel visualization technique was implemented to see through PVDF membranes and confirm air gap behavior. The experiments were compared with numerical modeling of AGMD film-wise condensation and flooded-gap MD. The results indicate that the introduction of superhydrophobic surfaces can result in improvements in distillate production in excess of 60% over standard AGMD. However, for high distillate production, condensation on the superhydrophobic plate transitions from a partially wetted droplet morphology to Wenzel flooded (wetting) conditions. Mildly hydrophobic condensing surfaces were found to provide moderate improvement in distillate production. Superhydrophobic support meshes made a negligible difference in distillate production, but high conductivity support meshes showed significant increases in flux at the expense of increased conduction losses. The results outline recommended superhydrophobic condensation conditions at varied feed and cold side temperatures for substantial improvement to distillate production rate for AGMD systems in a flat plate configuration.
Modulation and Coding for the Magnetic Recording Channel

Modern communications theory has played a major role in increasing the efficiency and reliability of communication systems. For example, whereas a few years ago the highest speed modems for transmitting data over the telephone network operated at 2400 bits per second, now a new generation of modems have been announced which transmit at 19,200 bits per second [1]. These modems employ a clever use of error correcting codes and modulation coupled with maximum likelihood (Viterbi) decoding [2].
Differential effects of ethanol on the expression of cyclo-oxygenase in cultured cortical astrocytes and neurons.

The developing central nervous system is a primary target of ethanol toxicity. The teratogenic effect of ethanol may result from its action on prostaglandins. Prostaglandins are generated through the release of arachidonic acid (AA) by the action of cytosolic phospholipase A2 (cPLA2) on membrane-bound phospholipids and the catalytic conversion of AA to prostaglandin E2 (PGE2) by cyclo-oxygenase (COX). COX is expressed in two isoforms, constitutive COX1 and inducible COX2. Cultured astrocytes and neurons from immature cerebral cortex were used as in vitro models to investigate the effect of ethanol on PGE2 synthesis. In both cell types, neither the activity nor the expression of cPLA2 was affected by ethanol. PGE2 was synthesized by astrocytes and neurons. Ethanol (200–400 mg/dL for 24 h) significantly increased PGE2 production in both cell types and the ethanol-induced increase in PGE2 accumulation in astrocytes was significantly greater than in neurons. These increases resulted from the effects of ethanol on COX. Overall COX activity was up-regulated by ethanol in astrocytes and neurons, and indomethacin, a nonselective blocker for COX, eliminated the ethanol-induced increases of COX activity in both cell types. Increased COX activity in astrocytes resulted from an increase in COX2 expression. NS-398, a selective COX2 blocker, completely inhibited ethanol-induced alterations in COX activity. In neurons, however, ethanol had a direct effect on COX activity in the absence of a change in COX expression. NS-398 only partially blocked ethanol-induced increases in neuronal COX activity. Thus, astrocytes are a primary target of ethanol and ethanol-induced increases in glial PGE2 synthesis are mediated by COX, principally COX2. Ethanol toxicity may be mediated through PGE2 in immature cortical cells.
Psychology and Business Ethics

We review the contribution of psychological science to the field of business ethics by discussing three major shifts that have occurred in scholarly work in the area. The first shift occurred from the cognitive-developmental perspective, at a time when moral reasoning was thought to be a rational mental process. The second shift advanced the role of emotional, intuitive, and largely automatic processes in moral decision making. And the third, complementary shift highlighted the role of small changes in one's environment that can encourage ethical behavior. We then propose a fourth shift, suggesting that the field of business ethics could benefit from an expanded definition of ethical behavior based on recent findings in moral psychology which support the notion that ethics play a critical role in binding groups together into functional social units. Keywords: morality; psychology; business ethics; ethical behavior; decision making
In Situ Permeability Measurements inside Compaction Bands Using X‐Ray CT and Lattice Boltzmann Calculations

The paper presents some results of the characterization of microstuctural differences inside and outside compaction bands in natural sandstone. Specimens of Aztec sandstone were scanned at the synchrotron APS, at Argonne National Laboratory (USA). Porosity measurements obtained by image analysis show a sharp transition inside/outside the compaction band. Finally, preliminary permeability measurements were conducted via the lattice Boltzmann method and demonstrate the dramatic decrease in permeability caused by the reduced porosity inside the compaction band relative to the host rock.
Local correlation models

Local correlation models that meet the requirements of a theoretical model chemistry are discussed. Two types of models are considered. The first class uses a valence active space that associates one correlating orbital for each occupied valence orbital. In these models the fundamental quantity is the electron pair; even the simplest local approximation (perfect pairing) exactly treats an isolated electron pair in this active space. The second class of models uses no active space. In this case we argue that the most appropriate fundamental quantity is the atom; even the simplest local approximation (atoms-in-molecules) exactly treats an isolated atom.
Application of Risk Assessments in Crafting Drinking Water Regulations

Assessments of adverse health outcomes and estimations of health risks from contaminants of drinking water are used at several points in the overall development of U.S. drinking water regulations. They are applied during the extensive discussions surrounding consideration of a contaminant's risk and approaches to risk mitigation, and in the required elements of National Primary Drinking Water Regulation (NPDWR) proposals, support documents, and final rules. Risk assessments are of several types with substantially different intents and characteristics. No one approach fits all applications. The type of assessment chosen depends on the application and the nature and availability of relevant data. The regulatory process starts with the identification of a constituent as either a possible contaminant of drinking water or as having some adverse toxicological or pathogenic properties. Available health data are then collected and analyzed, leading to the possible development of a toxicological profile of adverse health outcomes and dose–response characteristics. This is then coupled with occurrence data and exposure estimates to provide an estimate of national public health impact. Keywords: risk assessments; regulatory process; Cryptosporidium; epidemiologic data; dose–response assessment; exposure estimates; safe drinking water act; maximum contaminant level; no-observed-adverse-effect level (NOAEL)
Cicatrizing and autoimmune diseases.

Autoimmune disorders of the ocular surface represent a clinically heterogeneous group of conditions where acute and chronic autoreactive mechanisms can cause significant damage to the eye. When seve
Resistance to Technological Change in Academia

Initiating changes in technology, promoting utilization, and managing resistance by faculty may be among the most pressing challenges for academic leadership. Change that involves new technology is an ideal example of the systemic nature of organizational change because it includes infrastructure, expert knowledge, training, long-term vision, cost-benefit equations, and sufficient utilization to sustain the change. The literature on organizational change supports this premise that is exemplified in this article by anecdotal evidence from two universities. The first example describes the challenges in promoting utilization of Internet2 technology and the second describes the introduction of a project involving Voice-over Internet Protocol.
Interannual variation in global vegetation, precipitation, land surface temperature and sea surface temperature

A monthly global satellite-derived vegetation dataset for the 1980s has become available. This dataset has been used to investigate linkages between land surface temperature, sea surface temperature, precipitation and vegetation greenness at a global scale. The results indicate a linkage at mid- and high latitudes between climatic variations in sea surface temperature and land surface temperature that affect land surface vegetation in temperate climates. Precipitation was affected to a much smaller extent at these latitudes. More localized positive linkages were found at low latitudes between sea surface temperature, precipitation, and vegetation greenness. Land surface temperature showed a reversed relationship between rainfall and vegetation greenness in these regions. The positive coupling between sea surface temperature, land surface temperature, and vegetation greenness in midlatitudes suggests that increased land surface temperatures, as observed over the last 4 decades, should produce more vegetation growth, perhaps resulting in a carbon sink over this period.
Attachment Style, Representations of Psychotherapy, and Clinical Interventions With Insecurely Attached Clients

The primary aim of this article was to demonstrate the clinical utility of an empirically grounded perspective on the complex interplay between patients' attachment style and their ability to create, remember, and use benignly influential representations of their experiences with their therapists. We focused on 2 interrelated questions: Are there significant attachment-related differences in the thematic content of the remembrances and fantasies that patients have about therapy? And, if so, what are the implications for practice? Results of a study of individuals currently in therapy (N = 176) indicated that although all the patients with different insecure attachment styles struggled to evoke positively valenced therapist representations, the specific nature of their representational patterns varied as a function of specific attachment styles. We offer several clinical strategies that may increase insecure patients' abilities to form adaptive representations of their therapist and therapy. We illustrate our recommendations by presenting case material from the psychotherapy of a compulsively self-reliant man.