cssi/SciSciGPT-SciSciNet huggingface dataset:
Revisiting virtual L1 caches: A practical design using dynamic synonym remapping

Virtual caches have potentially lower access latency and energy consumption than physical caches because they do not consult the TLB prior to cache access. However, they have not been popular in commercial designs. The crux of the problem is the possibility of synonyms. This paper makes several empirical observations about the temporal characteristics of synonyms, especially in caches of sizes that are typical of L1 caches. By leveraging these observations, the paper proposes a practical design of an L1 virtual cache that (1) dynamically decides a unique virtual page number for all the synonymous virtual pages that map to the same physical page and (2) uses this unique page number to place and look up data in the virtual caches. Accesses to this unique page number proceed without any intervention. Accesses to other synonymous pages are dynamically detected, and remapped to the corresponding unique virtual page number to correctly access data in the cache. Such remapping operations are rare, due to the temporal properties of synonyms, allowing a Virtual Cache with Dynamic Synonym Remapping (VC-DSR) to achieve most of the benefits of virtual caches but without software involvement. Experimental results based on real world applications show that VC-DSR can achieve about 92% of the dynamic energy savings for TLB lookups, and 99.4% of the latency benefits of ideal (but impractical) virtual caches for the configurations considered.
Drawing the Line: An Exploratory Study of Single College Student Perceptions of Marital Boundaries in Opposite Sex Relationships

ABSTRACTMarital boundary expectations among single young adults are examined within the context of gender and religiosity among a diverse single young adult sample (n = 422) consisting of college students residing in California, Utah, and Nebraska. Participants (ages 18–29, M = 22.42) completed an online survey and were given extra credit for their participation. The results show that these young adults tend to perceive the need for communication and gift-giving boundaries within the context of heterosexual marriages. Analyses also indicate a trend for women to have higher perceptions of marital boundaries than men and for religiosity (assessed in two different ways) to be linked with marital boundaries. Limitations and recommendations are discussed.
Approach the Dispening Pattern of Work

Objective Approach the transition of the dispensing pattern of work in hospital.Methods Analysis the superiority and insufficient in the zero distance dispensing mode of dispensary for outpatients and single dose dispensing in dispensary for inpatients and the prepare center of pharmacy intravenous admixture.Results The dispensing pattern of work comply with the change from the dispensing mode of medicine supply to the dispensing mode of pharmaceutical care to put patient into center,to expend the service connotation of hospital pharmacy work.Conclusion The pattern in favour to promote rational use and to increase the level of pharmaceutical care in hospital and to embody the social value of pharmacist.The launch of new work mode need pharmacy technicist with high diathesis and the strongly support of nation policy.
Schatzker I/II Tibia Plateau Fracture

The patient is a 39-year-old female involved in a low-speed motor vehicle accident in which her car was rear-ended and then fishtailed into an embankment. On arrival to the emergency department, her Glascow Coma Scale was 15, and she was complaining of bilateral knee pain. Plain radiographs of bilateral knees demonstrated split-depression fractures of bilateral lateral tibial plateaus (Shatzker II). Computed tomography scans of both knees were obtained, and the diagnosis was confirmed. The patient was then taken to the operating room the same day for operative fixation of bilateral tibial plateaus (Figs. 1.1 and 1.2).
Resonance energy transfer microscopy.

Publisher Summary Scientists have long sought technical approaches that would allow them to study the real-time behavior of cellular functions at the subcellular level. Fluorescence, which is the emission of photons that occur as the electrons in a chromophore decay from an excited state back to the ground state, has provided a tool by which scientists can examine various cellular properties. This chapter discusses how fluorescence can be used as a spectroscopic ruler to measure distances among cellular components and gain information about the interactions of these components on the molecular level. This method, known as “resonance energy transfer (RET),” is founded on the fact that a fluorophore (donor) in an excited state may transfer its excitation energy to a neighboring chromophore (acceptor) nonradiatively through dipole–dipole interactions. This process requires some spectral overlap between the emission spectrum of the donor and the absorption spectrum of the acceptor and, for a given donor-acceptor pair, the efficiency of the transfer process is dependent on their relative orientation and on the distance between them.
Fungal Cystitis: Awareness, Diagnosis and Treatment

We report 4 cases of fungal cystitis. All patients had severe urgency, frequency and nocturia with sterile pyuria and microhematuria. Significant fungal growth was observed on routine blood agar cultur. Bladder biopsy was necessary to rule out tumor. Of the patients none responded to watchful waiting, 1 responded to intermittent daily bladder instillation of amphortericin B, 2 improved with oral 5-fluorocytosine, in addition to amphotericin B bladder instillations, and 1 required intravenous amphotericin B after unsuccessful response to 5-fluorocytosine and amphotericin B bladder treatments.
Understanding School Boards and Their Use of Different Models of Governance

In this article, the authors apply Mel Gill’s (2002) description of governance model types to a national sample of school board members in the United States. The authors find that the majority of school board members take a policy-driven approach to board governance, while a substantial percentage take a traditional approach that delegates clear authority to the organization executive. Multinomial-logistic regression analysis and a series of analysis of variance tests are used to identify the structural and group dynamic differences between difference governance model types. The authors find that governance models have an impact on the group dynamics of organizations and that board approaches to governance differ substantially by area, concluding that future studies of governance models should consider the differences in governance strategies across functional areas.
High-resolution esophageal manometry: interpretation in clinical practice.

Purpose of reviewEsophageal high-resolution manometry (HRM) is the current state-of-the-art diagnostic tool to evaluate esophageal motility patterns and, as such, is widely adopted in clinical practice. This article will review the interpretation of esophageal HRM in clinical practice.Recent finding
Dermatoses with Minimal Epidermal Changes

This group of skin disorders is clinically varied but characterized histologically by an inflammatory infiltrate primarily localized to the dermis. Some of the described conditions represent reactive cutaneous processes or phenotypic demonstrations of genetic mutations while others are idiopathic.
Dietary Therapy in Eosinophilic Esophagitis

Eosinophilic esophagitis is characterized by dense mucosal eosinophilia with symptoms of esophageal dysfunction. Because the incidence and prevalence are increasing, understanding the available treatments is imperative. This article highlights evolution and advancements in dietary treatment, supports the notion that food antigens drive this disease, and discusses the advantages, limitations, and future of dietary therapy. Medical and dietary therapies are effective treatments and the optimal approach should be individualized based on patient goals and available local resources. Dietary therapy has been effective and further studies will help identify optimal approaches to dietary therapy.
Perinatal palliative care: Integration in a United States nurse midwifery education program

Abstract Midwifery students with perinatal palliative care education develop a skillset to provide holistic midwifery care to women and families who are experiencing stillbirth or life-limiting fetal diagnoses. This paper presents a model of perinatal palliative care in a United States midwifery education program. By utilizing evidence based practices and national programs, perinatal palliative care can be threaded through midwifery curricula to achieve international standards of practice and competencies. Most importantly, enhancing perinatal palliative care education will better prepare future midwives for when a birth outcome is not what was expected at the outset of a pregnancy.
Detection of toxigenic Clostridium difficile colonization in patients admitted to the hospital for chemotherapy or haematopoietic cell transplantation.

Increasing evidence suggests that asymptomatic carriers are an important source of healthcare-associated Clostridium difficile infection. However, it is not known which test for the detection of C. difficile colonization is most sensitive in patients with haematological malignancies. We performed a prospective cohort study of 101 patients with haematological malignancies who had been admitted to the hospital for scheduled chemotherapy or haematopoietic cell transplantation. Each patient provided a formed stool sample. We compared the performance of five different commercially available assays, using toxigenic culture as the reference method. The prevalence of toxigenic C. difficile colonization as determined by toxigenic culture was 14/101 (14 %). The Cepheid Xpert PCR C. difficile/Epi was the most sensitive test for the detection of toxigenic C. difficile colonization, with 93 % sensitivity and 99 % negative predictive value. Our findings suggest that the Xpert PCR C. difficile/Epi could be used to rule out toxigenic C. difficile colonization in this population.
Current Trends in Interaction Research

This chapter seeks to identify major components of a developing interaction paradigm. As mentioned in the introductory chapter, such intellectual frameworks consist of the analytical units, assumptions, and unsolved questions which direct systematic research into any topic (Kuhn 1970). The particular paradigm we are attempting to elucidate focuses on predictable relations among extrasocietal contacts and sociopolitical changes. The views advanced here are those of the authors alone. Although considerably inspired by the chapters in this volume, and the “schools of thought” they represent, there is no reason to assume that the contributors concur with the ideas we express. Our objective, in fact, is not just to exercise an editor’s prerogative to have the last word. Rather, we are writing this essay as a contribution to the formulation of an interaction paradigm and not under any delusion that our statements are definitive. If the chapter encourages constructive debate on the systemic relations between sociopolitical change and intersocietal contacts, then it will have been successful.
Assessing Vocational Capacity: The Role of the Physician

A formidable task for our centers of medical learning is to educate physicians-those in training and those already practicing-as to the importance of objective medical vocational assessment. At present, the medical assessment of work potential is, at times, subjective. The circumstances under which a physician sees a patient to determine the extent of work-limiting impairment vary greatly. Establishment of causality of injury/disease, limiting assessment to what is vocationally relevant, and medical concerns of the employer may all complicate the traditional doctor-patient relationship.
Gay and Lesbian Movements

This article is a revision of the previous edition article by D. Altman, volume 9, pp. 5895–5899, © 2001, Elsevier Ltd.
Tracking a Markov Target in a Discrete Environment With Multiple Sensors

In this paper, we consider using multiple noisy binary sensors to track a target that moves as a Markov Chain in a finite discrete environment, with symmetric probability of false alarm and missed detection. We study two policies. First, we show that the greedy policy, whereby $m$ sensors are placed at the $m$ most-likely target locations, is one-step optimal in that it maximizes the expected maximum a posteriori (MAP) estimate. Second, we show that a policy in which the $m$ sensors are placed in the second through $(m+1)$ st most likely target locations achieves equal or slightly worse expected MAP performance, but leads to significantly decreased variance on the MAP estimate. The result is proven for $m = 1$ , and Monte Carlo simulations give evidence for $m > 1$ . Both policies are closed loop, index-based active sensing strategies that are computationally trivial to implement. Our approach focuses on one-step optimality because of the apparent intractability of computing an optimal policy via dynamic programming in belief space. However, Monte Carlo simulations suggest that both policies perform well over arbitrary horizons.
Deep Latent Generative Models for Energy Disaggregation

Thoroughly understanding how energy consumption is disaggregated into individual appliances can help reduce household expenses, integrate renewable sources of energy, and lead to efficient use of energy. In this work, we propose a deep latent generative model based on variational recurrent neural networks (VRNNs) for energy disaggregation. Our model jointly disaggregates the aggregated energy signal into individual appliance signals, achieving superior performance when compared to the state-of-the-art models for energy disaggregation, yielding a 29% and 41% performance improvement on two energy datasets, respectively, without explicitly encoding temporal/contextual information or heuristics. Our model also achieves better prediction performance on lowpower appliances, paving the way for a more nuanced disaggregation model. The structured output prediction in our model helps in accurately discerning which appliance(s) contribute to the aggregated power consumption, thus providing a more useful and meaningful disaggregation model.
Abstract 58: Neuronal Activation of Ras-Related C3 Botulinum Toxin Substrate 1 (Rac1) Improves Post-Stroke Recovery and Axonal Plasticity in Mice

Axonal plasticity is critical for functional recovery after stroke. Our previous study suggested that Rac1, a small GTPase, contributes to post-stroke axonal regeneration. However, the specific cel...
Clinical signs versus the pan-investogram.

In this age of increasing diagnostic aids, the role of clinical skills is in danger of becoming less important. Hospital assessments are driven by complex blood, laboratory, and radiological investigations, with diagnosis often led by clinical pathology rather than clinical examination. The ‘pan-investogram’ is often unleashed early rather than clinical assessment determining the appropriate and carefully selected investigations. Results are perceived as objective whereas clinical examination findings are thought more subjective and less reliable. I recall a 19-year old woman presenting one Monday morning with right iliac fossa pain (RIF) and some rebound and guarding, but no vomiting. There was no relevant gynaecological history, which can often muddy the waters, but I did arrange some immediate blood tests. She was asked to return to surgery …
The evolution of poor food access over the course of the conflict in Yemen

Abstract Yemen has undergone a profound transformation following the escalation of conflict in March of 2015 that has resulted in widespread food insecurity and the threat of famine. Given the lack of physical access to much of the country and the pressing need for humanitarian assistance, one of the manners in which assistance is targeted is according to the proximity of households to the ongoing violence. However, the temporal and regional patterns of poor food access suggest that there is little correlation between the geographic location of violence and food insecurity. Rather, we demonstrate that violence can affect supply chains and have an impact on food security beyond the location where the violence occurs. Although violence has a strong effect on food security, the lack of a relationship between geographic location of violence and poor food access contrasts with the rationale underpinning portions of the humanitarian and development assistance currently being delivered in the country.
Comparing the effects of a news article’s message and source on fracking attitudes in an experimental study

The present research examines the combined role of the message and source of a news article in persuading political partisans about an environmental policy. In a series of three experiments, we presented participants (total N = 3457) with a realistic news article summarizing scientific evidence concerning the environmental and economic costs and benefits of hydraulic fracturing (fracking). The article’s message was manipulated to support either a conservative (pro-fracking) or liberal (anti-fracking) policy and was attributed to either a conservative news source (Fox News) or a liberal one (MSNBC). Participants who read pro-fracking articles were generally more supportive of fracking than those who read anti-fracking articles, regardless of whether articles were from an ideologically friendly or unfriendly source. Consistent with previous research, however, participants perceived articles with ideologically unfriendly messages to have worse methods than articles with ideologically friendly messages. Finally, liberal participants showed some reduction in resistance to ideologically unfriendly messages coming from an ideologically friendly source, but conservative participants did not. Implications for politicization of environmental policy and future research are discussed.
Maternal Health after Stillbirth: Postpartum Hospital Readmission in California.

Objective The aim of this study is to assess whether the risk of postpartum readmission within 6 weeks of giving birth differs for women who had stillbirths compared with live births. Study design Using data from the Office of Statewide Health Planning and Development in California, we performed a population-based cohort study of 7,398,640 births between 1999 and 2011. We identified diagnoses and procedures associated with the first postpartum hospital readmission that occurred within 6 weeks after giving birth. We used log-binomial models to estimate relative risk (RR) of postpartum readmission for women who had stillbirth compared with live birth deliveries, adjusting for maternal demographic, prepregnancy, pregnancy, and delivery characteristics. Results The rate of postpartum readmission was higher among women who had stillbirths compared with women who had live births (206 and 96 per 10,000 births, respectively). After adjusting for maternal demographic and medical characteristics, the risk of postpartum readmission for women who had stillbirths was nearly 1.5 times greater (adjusted RR = 1.47, 95% confidence interval: 1.35-1.60) compared with live births. Among women with stillbirths, the most common indications at readmission were uterine infection or pelvic inflammatory disease, psychiatric conditions, hypertensive disorder, and urinary tract infection. Conclusion Based on our findings, women who have stillbirths are at higher risk of postpartum readmissions within 6 weeks of giving birth than women who have live births. Women who have stillbirths may benefit from additional monitoring and counseling after hospital discharge for potential postpartum medical and psychiatric complications. Key points · Women who have stillbirths are at nearly 1.5 times greater risk of postpartum readmission than women who have live births.. · Uterine infections and pelvic inflammatory disease, and psychiatric conditions are the most common reasons for readmission among women who had a stillbirth.. · Women who have stillbirths may benefit from additional monitoring and counseling after hospital discharge for potential postpartum medical and psychiatric complications..
The Free and Social Self

Popular assumptions and contemporary social thought alike now question the possibility of individual freedom or personal unity. The individual is assumed to be buffeted about and split internally by forces over which he has no control. Even his self conception is interpreted in derivative terms. This contemporary vision also makes genuine social relationships problematical. For social experience is not possible if men relate as automatons. A theory that places the individual’s nature and development largely within his own control is, Hocking believes, necessary to an acceptable theory of society. And participation in large and small social groups must be essential to the individual’s fulfillment if social relationships are to be more than mere additional restrictions on his liberty. An “individualistic theory of society” must not only defend human freedom and sociality, but also must integrally relate the two. Hocking develops such a theory and argues that it offers a more comprehensive analysis of human experience than other twentieth century alternatives.
Multisystem Inflammatory Syndrome in Children Associated with Severe Acute Respiratory Syndrome Coronavirus 2 Infection (MIS-C): A Multi-institutional Study from New York City.

Objective To assess clinical characteristics and outcomes of severe acute respiratory syndrome coronavirus 2-associated multisystem inflammatory syndrome in children (MIS-C). Study design Children with MIS-C admitted to pediatric intensive care units in New York City between April 23 and May 23, 2020, were included. Demographic and clinical data were collected. Results Of 33 children with MIS-C, the median age was 10 years; 61% were male; 45% were Hispanic/Latino; and 39% were black. Comorbidities were present in 45%. Fever (93%) and vomiting (69%) were the most common presenting symptoms. Depressed left ventricular ejection fraction was found in 63% of patients with median ejection fraction of 46.6% (IQR, 39.5-52.8). C-reactive protein, procalcitonin, d-dimer, and pro-B-type natriuretic peptide levels were elevated in all patients. For treatment, intravenous immunoglobulin was used in 18 (54%), corticosteroids in 17 (51%), tocilizumab in 12 (36%), remdesivir in 7 (21%), vasopressors in 17 (51%), mechanical ventilation in 5 (15%), extracorporeal membrane oxygenation in 1 (3%), and intra-aortic balloon pump in 1 (3%). The left ventricular ejection fraction normalized in 95% of those with a depressed ejection fraction. All patients were discharged home with median duration of pediatric intensive care unit stay of 4.7 days (IQR, 4-8 days) and a hospital stay of 7.8 days (IQR, 6.0-10.1 days). One patient (3%) died after withdrawal of care secondary to stroke while on extracorporeal membrane oxygenation. Conclusions Critically ill children with coronavirus disease-2019-associated MIS-C have a spectrum of severity broader than described previously but still require careful supportive intensive care. Rapid, complete clinical and myocardial recovery was almost universal.
Non-strange baryons (CLAS)

Baryon spectroscopy is an essential tool in the study of nucleon resonances. The use of polarization observables can greatly clarify the spectrum of broad and overlapping nucleon excitations. The N * program with the CEBAF Large Acceptance Spectrometer (CLAS) at the Thomas Jefferson National Accelerator Facility includes experimental studies with linearly- and circularly-polarized tagged-photon beams, longitudinally- and transversely-polarized nucleon targets, and recoil polarizations. An overview of these experimental studies and recent results are presented.
The clinical significance of small sharp spikes: A retrospective study of 909 patients in epilepsy monitoring unit

Abstract Objectives To determine the incidence and clinical significance of small sharp spikes (SSS) in the patient population of the adult Epilepsy Monitoring Unit (EMU). Methods This is a retrospective study of EEG data and medical records from consecutive patients who underwent video-EEG recording in the adult EMU from March 2013 to February 2019. SSS, interictal epileptiform discharges (IEDs), and ictal patterns were identified. Results Of the 909 patients reviewed, SSS were observed in110 (12.1 %) patients. Epilepsy was present in 101 of the 110 (91.8 %) patients with SSS and in 441 of the 799 (55.2 %) patients without SSS. The incidence of epilepsy was significantly higher in patients with SSS than in those without SSS (OR = 9.1, 95 % CI: 4.5–18.3, P Conclusions There is a statistically significant association between SSS and focal epilepsy. SSS have similar clinical implications to IEDs in the lateralization and localization of temporal lobe seizures. SSS can be an epileptiform EEG pattern for temporal lobe epilepsy.
Dose response of a novel exogenous ketone supplement on physiological, perceptual and performance parameters.

Interest into the health, disease, and performance impact of exogenous ketone bodies has rapidly expanded due to their multifaceted physiological and signaling properties but limiting our understanding is the isolated analyses of individual types and dose/dosing protocols. Thirteen recreational male distance runners (24.8 ± 9.6 years, 72.5 ± 8.3 kg, VO2max 60.1 ± 5.4 ml/kg/min) participated in this randomized, double-blind, crossover design study. The first two sessions consisted of a 5-km running time trial familiarization and a VO2max test. During subsequent trials, subjects were randomly assigned to one (KS1: 22.1 g) or two (KS2: 44.2 g) doses of beta-hydroxybutyrate (βHB) and medium chain triglycerides (MCTs) or flavor matched placebo (PLA). Blood R-βHB, glucose, and lactate concentrations were measured at baseline (0-min), post-supplement (30 and 60 min), post-exercise (+ 0 min, + 15 min). Time, heart rate (HR), rating of perceived exertion (RPE), affect, respiratory exchange ratio, oxygen consumption (VO2), carbon dioxide production, and ventilation were measured during exercise. Cognitive performance was evaluated prior to and post-exercise. KS significantly increased R-βHB, with more potent and prolonged elevations in KS2, illustrating an administrative and dosing effect. R-βHB was significantly decreased in KS1 compared to KS2 illustrating a dosing and exercise interaction effect. Blood glucose elevated post-exercise but was unchanged across groups. Blood lactate significantly increased post-exercise but was augmented by KS administration. Gaseous exchange, respiration, HR, affect, RPE, and exercise performance was unaltered with KS administration. However, clear responders and none-responders were indicated. KS2 significantly augmented cognitive function in pre-exercise conditions, while exercise increased cognitive performance for KS1 and PLA to pre-exercise KS2 levels. Novel βHB + MCT formulation had a dosing effect on R-βHB and cognitive performance, an administrative response on blood lactate, while not influencing gaseous exchange, respiration, HR, affect, RPE, and exercise performance.
A novel OCT signature in leukemic papillopathy masquerading as autoimmune or infectious uveitis

With therapeutic advances, central nervous system (CNS) involvement in leukemia has become more common. Leukemic optic disc infiltration, often a clinical diagnosis, can present as an isolated finding in primary or relapsed CNS disease and therefore requires early recognition. Not previously well appreciated, we report here signs of intraocular inflammation accompanying leukemic optic disc infiltration, suggesting infectious or non-infectious uveitis as an alternative diagnosis. We describe a novel optical coherence tomography (OCT) sign favoring leukemic infiltration. Retrospective consecutive case series of all leukemic patients with disc edema (5 patients, 6 eyes) presenting to the University of Michigan’s Ocular Oncology Clinic between October 2019 and March 2020. We report five leukemic patients (6 eyes) who were evaluated for disc edema and vitritis and eventually diagnosed with leukemic papillopathy. All five patients initially had a bland lumbar puncture (LP), and all four patients who underwent magnetic resonance imaging (MRI) had no retrobulbar nerve involvement. Clinical findings included preserved visual acuity (n = 5 eyes, 83%), anterior chamber (AC) cell (n = 3 eyes, 50%), vitreous cell (n = 6 eyes, 100%), and retinal whitening (n = 4 eyes, 66%). In five eyes (83%), a diagnosis of infectious or non-infectious uveitis was initially considered. The OCT finding of inner retinal thickening and loss of inner retinal lamination with largely preserved outer retinal architecture helped point towards a leukemic infiltrative process emanating from the disc and spreading retrograde through the nerve fiber layer. These cases highlight the difficulty of distinguishing intraocular inflammation associated with leukemic papillopathy from infectious or non-infectious uveitis, especially considering bland LP and negative retrobulbar MRI signal in all our patients. We propose juxtapapillary inner retinal infiltration with the loss of inner retinal lamination and relative preservation of outer retinal architecture on OCT imaging as a finding that supports the diagnosis of leukemic papillopathy.
Strategic Entrepreneurs at Work: The Nature, Discovery, and Exploitation of Entrepreneurial Opportunities

What do entrepreneurial opportunities look like? How do firms discover and exploit these opportunities to create value and sustain competitive advantage? This paper reviews the strategic management and entrepreneurship literatures to identify the nature and character of entrepreneurial opportunities and the entrepreneurial strategies that firms employ to seize and commercialize these opportunities. Three emerging schools are identified. The economic school argues that entrepreneurial opportunities exist as a result of the distribution of information about material resources in society. The cultural cognitive school argues that entrepreneurial opportunities exist as a result of environmental ambiguity and the cultural resources available to interpret and define these opportunities. Finally, the sociopolitical school stresses the role of network and political structures in defining entrepreneurial opportunities. We integrate these perspectives to offer a way to improve understanding of the opportunity creation and exploitation process.
Higher prevalence of hysterectomy among rural women than urban women: Implications for measures of disparities in uterine and cervical cancers.

Purpose Differences in hysterectomy prevalence by rural or urban residence could distort comparisons of rural-urban cervical and uterine cancer incidence. Using data from a large population-based survey, we sought to understand whether hysterectomy prevalence varies by rural or urban residence and whether the relationship between hysterectomy prevalence and rurality varies by race or ethnicity. Methods Our analysis included 197,759 female respondents to the 2018 Behavioral Risk Factor Surveillance System, aged 20-79 years. We calculated population weighted proportions and 95% confidence intervals for hysterectomy prevalence, stratified by rural-urban residence and 5-year age groups. We also report estimates of hysterectomy prevalence by rural-urban residence for specific race and ethnic groups. Findings Hysterectomy prevalence increased with age and was more common among rural women than urban women. The largest absolute difference occurred among women aged 45-49 years; 28.6% of rural women (95% CI: 25.1-32.2) and 16.6% of urban women (95% CI: 15.3-17.8) reported a hysterectomy. For hysterectomy prevalence by race and ethnicity, rural estimates were higher than urban estimates for the following groups of women: non-Hispanic Asian, non-Hispanic other race, non-Hispanic Black, and non-Hispanic White. Among Hispanic women and non-Hispanic American Indian/Alaska Native women, rural-urban differences in hysterectomy prevalence were not statistically different at the 95% confidence level. Conclusions Our results suggest that variation in hysterectomy prevalence, if not adjusted in the analysis, could produce distorted comparisons in measures of the relationship between rurality and uterine and cervical cancer rates. The magnitude of this confounding bias may vary by race and ethnicity.
Patterns of Incorporation of [3H]Galactose by Cells of Zea Mays Root Tips

[ 3 H]galactose shows a selective pattern of uptake distribution in the apical portion of the root tip of Zea mays . In cells entering division it is incorporated into the Golgi apparatus within 10 min and is transferred from that organelle to the forming cell plate. The pattern of uptake suggests a specific biochemical activity on the part of the Golgi apparatus at the time of division so far as the incorporation of galactose is concerned. Apparently little galactose is converted to glucose in the most apical portion of the root. In normal secretory cells, the heaviest uptake is found in the sieve tube elements, epidermal cells and the outer cells of the root cap.
Jet Ventilation Algorithm Decreases Variations in Practice

Background: Variations in practice are common in most institutions based on training and previous experience. Our team sought to minimize those variations to improve patient outcomes and provide best practice for the care of our infants. Prior to the development and implementation of a jet algorithm, patients were initiated on our conventional ventilation protocol and only converted to the jet as a rescue modality, most commonly in our smallest patients within the first few days of life. Furthermore, once the patient was placed on jet ventilation, startup settings varied widely between clinicians and the patients’ clinical status. Variations included starting with or without sigh rates, peak inspiratory pressure range of the sigh rate, peak inspiratory pressure range for jet ventilation, and jet rate. Our goal was to develop a jet algorithm for the highest-risk patients and to decrease variability between providers. Methods: Multidisciplinary group was formed to develop a ventilation algorithm utilizing jet ventilation for patients with birth weight of 750 g or less of any gestational age that required intubation at birth or within the first 72 h of life. A literature search was performed to evaluate for potential algorithms, and it was noted that a similar institution had publicly provided reference to their developed algorithm. We also consulted with that institution to assure we interpreted their algorithm correctly. Our team created an algorithm similar in nature but, focused on our own institution’s findings of that many infants less than 750 g failed conventional ventilation. In May 2019, our first patient was placed on jet ventilation utilizing the algorithm. After PDSA cycles, slight variations have been made to the algorithm but nothing affecting the initial setup and implementation. Our primary process measure was compliance with the algorithm. Our primary outcome measure was the number of infants on the algorithm. Our balancing measure was the decrease in BPD. Results: From May 2019 to May 2021, 53 infants met criteria for inclusion into the jet algorithm. 49/53 (93%) of patients were appropriately placed on the Jet algorithm. Four patients were not placed on the Jet algorithm during this time; 2 due to extremely low ventilation and oxygenation needs immediately after birth and 2 due to sigh breaths. Conclusions: Based on all clinicians initiating and adjusting based on algorithm there has been a decrease in the variations of and patient are prophylactically placed on jet ventilation.
The Role of Immigrant Concentration Within and Beyond Residential Neighborhoods in Adolescent Alcohol Use.

Neighborhoods are salient contexts for youth that shape adolescent development partly through informal social controls on their behavior. This research examines how immigrant concentration within and beyond the residential neighborhood influences adolescent alcohol use. Residential neighborhood immigrant concentration may lead to a cohesive, enclave-like community that protects against adolescent alcohol use. But heterogeneity in the immigrant concentrations characterizing the places residents visit as they engage in routine activities outside of the neighborhood where they live may weaken the social control benefits of the social ties and shared cultural orientations present in enclave communities. This study investigates whether the protective influence of residential neighborhood immigrant concentration on adolescent alcohol consumption diminishes when youth live in communities where residents collectively are exposed to areas with more diverse immigrant concentrations. This study tests this contention by analyzing survey and geographic routine activity space data from the Los Angeles Family and Neighborhood Survey, and the 2000 census. The sample includes 793 adolescents (48.7 % female, 16.5 % foreign-born Latino, 42.5 % US-born Latino, 11.0 % black, 30 % white/other) between the ages of 12 and 17 who live in 65 neighborhoods in Los Angeles County. Immigrant concentration among these neighborhoods derives primarily from Latin America. The results from multilevel models show that immigrant concentration protects against adolescent alcohol use only when there is low neighborhood-level diversity of exposures to immigrant concentration among the contexts residents visit outside of their residential neighborhood. This research highlights the importance of considering the effects of aggregate exposures to non-home contexts on adolescent wellbeing.
Discoidins I and II: endogenous lectins involved in cell-substratum adhesion and spore coat formation.

Publisher Summary This chapter discusses the basic biochemical and biological techniques in identifying the functions of discoidins I and II. Like soluble lectins from vertebrates, they are apparently designed to play extracellular roles—discoidin I in cell–substratum adhesion and discoidin II in spore coat formation. A number of lines of evidence point to a role for discoidin I in a specific form of cell–substratum adhesion. Antibodies against the lectin and against a 67-kDa glycoprotein with properties of a discoidin I receptor both block ordered cell migration into aggregates. A mutant deficient in discoidin I does not aggregate normally. Nor does an antisense transformant in which there is a >90% reduction in discoidin I. One interesting conclusion from studies of the cellular role of discoidin 1 is that this lectin shares several properties with fibronectin, a vertebrate molecule implicated in the adhesion of fibroblasts to substrata. Like Fibronectin, discoidin I contains the sequence Arg-Gly-Asp-x, which has been implicated in the cell-binding properties of both molecules. Both molecules also have carbohydrate-binding sites. Firbronectin's binding sites for glycosaminoglycans may participate in anchoring it to the substratum. A role for discoidin II in spore coat formation is indicated by (1) its localization in vesicles which also contain a polysaccharide to bind well to this lectin, and (2) the secretion of lectin and the polysaccharide into the spore coat.
Differences between Diploid and Heteroploid Cultured Mammalian Cells in Their Response to Puromycin Aminonucleoside

Treatment of several heteroploid cultured mammalian cell lines with suitably low concentrations of aminonucleoside resulted in partial depression of ribosomal RNA synthesis, shown by methylated albumin-Kieselguhr column chromatography of labeled nucleic acids, and a lowering of the cell RNA content. These RNA-depleted heteroploid cell lines containued to proliferate at control rates for several cell generations. Proliferation of diploid cell lines, on the other hand, was inhibited by aminonucleoside without depression in cell RNA content. Methylated albumin-Kieselguhr chromatography of nucleic acids showed that the inhibition of ribosomal RNA synthesis was quickly followed by the inhibition of syntheses of the other types of RNA and of DNA. The inhibitory effects of amino-nucleoside on both heteroploid and diploid cells were prevented by simultaneous treatment with inosine, suggesting that the action of the inhibitor was similar in the cells studied, since uptake of labeled aminonucleoside into the cell was not affected by the nucleoside. These results show that the heteroploid cell has a greater capacity to proliferate when its rate of ribosomal RNA synthesis is depressed, probably because its ability to synthesize DNA has been freed from some of the controls present in diploid cells.
The unfolding story of the Escherichia coli Hsp70 DnaK: is DnaK a holdase or an unfoldase?

Summary We discuss recent experiments that have illuminated individual steps in the reaction cycle of the Escherichia coli Hsp70 molecular chaperone DnaK. Using this new information, we comparetwo distinctly different global mechanisms of action – holding versus unfolding – and argue that the available evidencesuggests that DnaK is an unfoldase.
Profiling quality of care: Is there a role for peer review?

We sought to develop a more reliable structured implicit chart review instrument for use in assessing the quality of care for chronic disease and to examine if ratings are more reliable for conditions in which the evidence base for practice is more developed. We conducted a reliability study in a cohort with patient records including both outpatient and inpatient care as the objects of measurement. We developed a structured implicit review instrument to assess the quality of care over one year of treatment. 12 reviewers conducted a total of 496 reviews of 70 patient records selected from 26 VA clinical sites in two regions of the country. Each patient had between one and four conditions specified as having a highly developed evidence base (diabetes and hypertension) or a less developed evidence base (chronic obstructive pulmonary disease or a collection of acute conditions). Multilevel analysis that accounts for the nested and cross-classified structure of the data was used to estimate the signal and noise components of the measurement of quality and the reliability of implicit review. For COPD and a collection of acute conditions the reliability of a single physician review was quite low (intra-class correlation = 0.16–0.26) but comparable to most previously published estimates for the use of this method in inpatient settings. However, for diabetes and hypertension the reliability is significantly higher at 0.46. The higher reliability is a result of the reviewers collectively being able to distinguish more differences in the quality of care between patients (p < 0.007) and not due to less random noise or individual reviewer bias in the measurement. For these conditions the level of true quality (i.e. the rating of quality of care that would result from the full population of physician reviewers reviewing a record) varied from poor to good across patients. For conditions with a well-developed quality of care evidence base, such as hypertension and diabetes, a single structured implicit review to assess the quality of care over a period of time is moderately reliable. This method could be a reasonable complement or alternative to explicit indicator approaches for assessing and comparing quality of care. Structured implicit review, like explicit quality measures, must be used more cautiously for illnesses for which the evidence base is less well developed, such as COPD and acute, short-course illnesses.
Nonhomotheticity and Bilateral Trade: Evidence and a Quantitative Explanation

The standard gravity model predicts that trade flows increase in proportion to importer and exporter total income, regardless of how income is divided into income per capita and population. Bilateral trade data, however, show that trade grows strongly with income per capita and is largely unresponsive to population. I develop a general equilibrium Ricardian model of trade that allows the elasticity of trade with respect to income per capita and with respect to population to diverge. Goods are of various types, which differ in their income elasticity of demand and in the extent to which there is heterogeneity in their production technologies. I estimate the model using bilateral trade data of 162 countries and compare it to a special case that delivers the gravity equation. The general model improves the restricted model's predictions regarding variations in trade due to size and income. I experiment with counterfactuals. A positive technology shock in China makes poor and rich countries better off and middle-income countries worse off.
Uptake of dissolved organic carbon and trace elements by zebra mussels

Zebra mussels (Dreissena polymorpha) are widespread and abundant in major freshwater ecosystems in North America, even though the phytoplankton food resources in some of these systems seem to be too low to sustain them. Because phytoplankton biomass is greatly depleted in ecosystems with large D. polymorpha populations and bacteria do not seem to be an important food source for this species, exploitation of alternative carbon sources may explain the unexpected success of D. polymorpha in such environments. Here we examine the possibility that absorption of dissolved organic carbon (DOC) from water could provide a nutritional supplement to zebra mussels. We find that mussels absorb 14C-labelled DOC produced by cultured diatoms with an efficiency of 0.23%; this indicates that DOC in natural waters could contribute up to 50% of the carbon demand of zebra mussels. We also find that zebra mussels absorb some dissolved metals that have been complexed by the DOM; although absorption of dissolved selenium was unaffected by DOC, absorption of dissolved cadmium, silver and mercury by the mussels increased 32-, 8.7- and 3.6-fold, respectively, in the presence of high-molecular-weight DOC.
Leaders in hospital-based social work: the roles and functions of directors of social work in the case management model.

Purpose – The purpose of this research is to provide an overview of the management skills and competencies required by a director of social work as they perform their multiple roles and functions in order to effectively manage a medical social work team to better serve the needs of patients through the new hospital‐based case management model.Design/methodology/approach – This is a conceptual paper that reviews the literature on managerial roles, management functions, and skills and competencies of directors of social work. Management frameworks that are applicable under the case management model are discussed. Interviews with five directors of social work and their perceptions are described.Findings – Managing a department that is going through continuous changes is often difficult.Practical implications – This paper has practical implications for general health care managers and specifically, directors of social work, to develop skills and gain competencies to be successful in today's evolving health ca...