cssi/SciSciGPT-SciSciNet huggingface dataset:
Successful use of minimal incision superficialization technique for arteriovenous fistula maturation.

Background Successful cannulation is an important prerequisite for a functional arteriovenous fistula (AVF). Reasons for unsuccessful cannulation of an AVF are multifactorial and poorly evaluated. In our experience, a needle access segment (NAS) with a length of 10 cm, 6 mm diameter assessed objectively using duplex Doppler ultrasound (DDUS) imaging, in a fistula with brachial artery flow >500 mL/min, permits consistent cannulation. This report provides observational data on the NAS of the outflow veins after fistula creation and a detailed long-term outcome on AVFs that needed superficialization of the NAS using minimal incision superficialization technique (MIST) to make them suitable for cannulation. This report is based on prospectively collected data with a longitudinal follow-up in a large patient cohort. Methods A prospective database was used to analyze consecutive patients undergoing AVF until the study end point. All patients underwent a protocol-based maturation evaluation using color DDUS imaging. Unsuitable NAS were surgically corrected using superficialization (by MIST or lipectomy) of deeply situated veins or NAS reconstruction. Results Between February 1, 2007, and May 31, 2013, 617 new AVF surgeries were performed. Outflow vein superficialization (MIST or lipectomy) or NAS reconstruction was necessary in 226 of 585 procedures (38.6%) included in this analysis. Of these, 162 (72%) were performed using MIST, 50 (22%) with a single long incision, and 14 (6%) using lipectomy technique. Technical success for MIST was 100%, and only two fistulae failed to mature. The vein depth of 9.2 ± 3.2 mm during initial vessel mapping was similar to the pre-MIST depth of 9.1 ± 3.8 mm. Depth of NAS improved to 3.1 ± 1.0 mm after MIST. The secondary patency after MIST at 6, 12, 24, 48, and 60 months was 98%, 93.3%, 88.1%, 83.3%, and 80.9%. During the 400.8 post-MIST functional fistula-years, only 0.63 procedures per year were required to maintain AVF patency. Conclusions Our data suggest that maturation of AVFs using objective criteria based on DDUS provides an opportunity to identify NAS problems in outflow veins before cannulation. Most of the of the AVF outflow veins (71.7%) could be transposed or superficialized using MIST, with excellent long-term outcomes.
Performance enhancement of a shaded light trapping solar module

This work presents a shaded light trapping solar module. The light trapping structures is disposed in the encapsulation structure located on the ribbon connectors in a cavity region between packaging material EV A and ribbon connector. The bus-bar shadow can be improved by a light trapping cavity related to internal total reflection of optical sheet.
Projected impacts of climate change on stream salmonids with implications for resilience-based management

The sustainability of freshwater fisheries is increasingly affected by climate warming, habitat alteration, invasive species and other drivers of global change. The State of Michigan, USA, contains ecologically, socioeconomically valuable coldwater stream salmonid fisheries that are highly susceptible to these ecological alterations. Thus, there is a need for future management approaches that promote resilient stream ecosystems that absorb change amidst disturbances. Fisheries professionals in Michigan are responding to this need by designing a comprehensive management plan for stream brook charr (Salvelinus fontinalis), brown trout (Salmo trutta) and rainbow trout (Oncorhynchus mykiss) populations. To assist in developing such a plan, we used stream-specific regression models to forecast thermal habitat suitability in streams throughout Michigan from 2006 to 2056 under different predicted climate change scenarios. As baseflow index (i.e., relative groundwater input) increased, stream thermal sensitivity (i.e., relative susceptibility to temperature change) decreased. Thus, the magnitude of temperature warming and frequency of thermal habitat degradation were lowest in streams with the highest baseflow indices. Thermal habitats were most suitable in rainbow trout streams as this species has a wider temperature range for growth (12.0–22.5 °C) compared to brook charr (11.0–20.5 °C) and brown trout (12.0–20.0 °C). Our study promotes resilience-based salmonid management by providing a methodology for stream temperature and thermal habitat suitability prediction. Fisheries professionals can use this approach to protect coldwater habitats and drivers of stream cooling and ultimately conserve resilient salmonid populations amidst global change.
Zinc Alloys for High Damping Applications–A First Progress Report

Low and high frequency damping experiments have been conducted on die cast zinc alloys, and damping capacity has been measured as a function of temperature at high frequencies. The alloys show excellent damping properties over the range from 5 Hertz to a few hundred Hertz, for service applications from 40-80 o C (104-176 o F)
Constitutively active mutant GS alpha (G225T) and null-mutant G alpha i-2 (G203T) induce primitive endoderm from stem cells.

In F9 teratocarcinoma stem cells, retinoic acid induces a primitive endoderm-like phenotype and a sharp decline in G alpha i-2, a response mimicked by expression of RNA antisense to G alpha i-2 in the absence of this morphogen (D. C. Watkins, G. L. Johnson, and C. C. Malbon. Science Wash. DC 258: 1373-1375, 1992). The role of the GS alpha/G alpha i-2 axis in cellular differentiation was explored. In the absence of retinoic acid, F9 stem cells stably expressing a constitutively active mutant of GS alpha (G225T) progressed to the primitive endoderm phenotype, as judged by morphological and differentiation markers, such as tissue plasminogen activator. Although elevated in cells expressing G225T GS alpha, adenosine 39,59-cyclic monophosphate does not mimic retinoic acid action and alone fails to induce stem cells to primitive endoderm. In the absence of retinoic acid, expression of a null mutant of G alpha i-2 (G203T) also induced stem cells to primitive endoderm. These observations establish G proteins in the GS alpha/G alpha i-2 axis as a control point for regulating progression to primitive endoderm independent of adenylate cyclase, in the present study9s model of early mouse development.
LASPOT — ein neuer Weg zur Fertigung von Stopperlagen auf Zylinderkopfdichtungen

Aktuell verfugen weltweit rund 50 % der Zylinderkopfdichtungen in Pkw uber Stopperlagen, die zum Beispiel durch Falten der betreffenden Funktionslage erzeugt werden (gebordelter Stopper). Bedingt durch den Produktionsprozess ist die Formgebung dieser Stopperzonen jedoch eingeschrankt. Auserdem muss bei der Verformung des Materials auf mogliche Veranderungen des Gefuges in der Biegezone geachtet werden. Federal-Mogul Sealing Systems fertigt auf einer neuen Anlage in Herdorf Zylinderkopfdichtungen, bei denen eine Stopperfolie durch Laserpunktschweisen aufgebracht wird.
“Conventional” CT images from spectral measurements

Spectral imaging systems need to be able to produce "conventional" images, and it's been shown that systems with energy discriminating detectors can achieve higher CNR than conventional systems by optimal weighting. Combining measured data in energy bins (EBs) and also combining basis material images have previously been proposed, but there are no studies systematically comparing the two methods. In this paper, we analytically evaluate the two methods for systems with ideal photon counting detectors using CNR and beam hardening (BH) artifact as metrics. For a 120-kVp polychromatic simulations of a water phantom with low contrast inserts, the difference of the optimal CNR between the two methods for the studied phantom is within 2%. For a polychromatic spectrum, beam-hardening artifacts are noticeable in EB weighted images (BH artifact of 3.8% for 8 EB and 6.9% for 2 EB), while weighted basis material images are free of such artifacts.
The Application of Rubber in the Quantitative Determination of Ozone

Abstract A convenient rubber cracking test for ozone is described. This method serves not only as a rapid, positive means of identifying ozone in complex gas mixtures but also gives close approximation to the quantity present. Application of the method in determining ozone in heavy smog atmosphere is shown. The high ozone concentration in these tests is attributed to ozone formation under the catalytic action of nitrogen oxides and sunlight.
Oxygen administration to preterm neonates in the delivery room: minimizing oxidative stress.

Background Neonatal resuscitation continues to be challenged by evolving research on the best approach to resuscitating preterm infants while minimizing potential health risks. The actions of the resuscitation team in the first minutes of transition to extrauterine life can have a lasting impact on the growth and development of the preterm infant. Purpose This article reviews the most current literature on the use of oxygen in the delivery room and discusses the implications related to nursing and the multidisciplinary care team. Findings Oxygen saturation monitoring in the delivery room through the use of pulse oximetry in conjunction with oxygen titration via a blended oxygen source is an appropriate intervention to decrease the risk of free radical damage to the tissues. Implications for practice Ensure delivery room providers are educated to resuscitation standards and ensure delivery rooms are appropriately supplied with a compressed air source, oxygen blenders, and pulse oximeters to minimize the free radical damage to the tissues. Implications for research Future studies should be focused on pulse oximetry use in the delivery room and its effect on long-term outcomes for preterm infants, safe oxygen saturation target ranges for the preterm infant in the delivery room, and effective resuscitation procedures for extremely preterm infants.
The Role of [M+O−] Centers (M+– Group IA Ion) in the Activation of Methane on Metal Oxides

If the ionic radii are compatible, alkali metal ions will substitute for the divalent metal ions in magnesium oxide, calcium oxide and zinc oxide. At high temperatures in the presence of molecular oxygen, centers of the type [M+O−] are formed, where MM+– Group IA ion. The O− ions in equilibrium with these centers are effective in H” abstraction from CH4, which is the first step in the oxidative dimerization reaction. At reaction temperatures >720°C alkali metal oxides formed on the catalytic surface may themselves become active centers. Alkali metal carbonates also may inhibit the activity of the host oxide and sinter the oxide, thereby eliminating corner sites which result in complete oxidation.
Catalytic, Self-Cleaning Surface with Stable Superhydrophobic Properties: Printed Polydimethylsiloxane (PDMS) Arrays Embedded with TiO2 Nanoparticles

Maintaining the long-term stability of superhydrophobic surfaces is challenging because of contamination from organic molecules and proteins that render the surface hydrophilic. Reactive oxygen species generated on a photocatalyst, such as TiO2, could mitigate this effect by oxidizing these contaminants. However, incorporation of such catalyst particles into a superhydrophobic surface is challenging because the particles become hydrophilic under UV exposure, causing the surface to transition to the Wenzel state. Here we show that a high concentration of hydrophilic TiO2 catalytic nanoparticles can be incorporated into a superhydrophobic surface by partially embedding the particles into a printed array of high aspect ratio polydimethylsiloxane posts. A stable Cassie state was maintained on these surfaces, even under UV irradiation, because of the significant degree of hierarchical roughness. By printing the surface on a porous support, oxygen could be flowed through the plastron, resulting in higher photoo...
Analysis on current clinical revaluation of hospital preparation in Shanghai

This paper explored the necessity and feasibility of hospital preparation revaluation based on the status survey of the medical institutions in Shanghai in 2008,in order to raise the awareness of the importance of hospital preparation revaluation and ensure the drug safety of patients.
Children's Theory of God's Mind: Theory-of-Mind Studies and Why They Matter to Religious Education

AbstractTheory-of-mind research has been carried out for over three decades, examining the ways children understand the minds of others—their perspectives, intentions, desires, and knowledge. Since the early 21st century, theory-of-mind studies have begun exploring the ways in which children think and reason about the minds—not only of ordinary, visible figures such as humans or animals—but of invisible figures such as spirits, angels, imaginary friends, and God. This growing body of research provides insight into children's cognitive development generally, but also into what could be called a “theory of religious mind.”
Non-asymptotic bounds for prediction problems and density estimation

This dissertation investigates the learning scenarios where a high-dimensional parameter has to be estimated from a given sample of fixed size, often smaller than the dimension of the problem. The motivation for the questions we study comes from real-world applications where the data is often obtained from expensive experiments and has to be processed and analyzed efficiently. The first part answers some open questions for the binary classification problem in the framework of active learning. Given a random couple (X, Y) ∈ Rd × {±1} with unknown distribution P, the goal of binary classification is to predict a label Y based on the observation X. The prediction rule is constructed from the observations (Xi, Yipni=1 sampled from P. The concept of active learning can be informally characterized as follows: on every iteration, the algorithm is allowed to request a label Y for any instance X which it considers to be the most informative. The contribution of this work consists of two parts: first, we provide the minimax lower bounds for the performance of active learning methods. Second, we propose an active learning algorithm which attains nearly optimal rates over a broad class of underlying distributions and is adaptive with respect to the unknown parameters of the problem. The second part of this thesis is related to sparse recovery in the framework of dictionary learning. Let (X, Y) be a random couple with unknown distribution P, with X taking its values in some metric space S and Y - in a bounded subset of R . Given a collection of functions H=ht t∈T mapping S to R , the goal of dictionary learning is to construct a prediction rule for Y given by a linear(or convex) combination of the elements of H . The problem is sparse if there exists a good prediction rule that depends on a small number of functions from H . We propose an estimator of the unknown optimal prediction rule based on penalized empirical risk minimization algorithm. We show that the proposed estimator is able to take advantage of the possible sparse structure of the problem by providing probabilistic bounds for its performance.
Effect of purity and surface modification on stability and oxidation kinetics of boron powders

Abstract A commercial 95-% pure boron was ultrasonicated in acetonitrile and then in toluene to remove the surface layer of boron oxide and boric acid. The powder suspended in acetonitrile forms stratified layers, with the bottom layer containing most of the material with the least amount of boron oxide and boric acid. The surface of the processed boron powder was modified with a protective layer, making it more stable in room temperature humid oxidizing environment than the reference 95-% pure commercial boron. The stability of different powders was characterized using isothermal calorimetry employing a thermal activity monitor TAM III with a perfusion ampoule. Oxidation of the surface modified boron powders was studied using thermal gravimetry and compared to oxidation of both 99 and 95-% pure commercial powders. At room temperature, the 99-% pure boron powder was the most stable. Upon heating, the 99-% boron begins oxidizing at a lower temperature than all the 95-% pure powders. However, the apparent activation energy of oxidation at elevated temperatures obtained using a model-free isoconversional methodology for the 95-% pure powder processed in both acetonitrile and toluene is lowest among all tested powders and is close to 100 kJ/mol. It is expected that the latter powder is the most attractive as a fuel, which will be characterized by the shortest ignition delays.
Euglycemic Diabetic Ketoacidosis Accompanied by Severe Hypophosphatemia During Recovery in a Patient With Type 2 Diabetes Being Treated With Canagliflozin/Metformin Combination Therapy

Euglycemic diabetic ketoacidosis (DKA) is defined as acidosis with a blood glucose level <300 mg/dL and bicarbonate level <10 mEq/L and is associated with ketonemia/ketonuria (1). It is usually caused by starvation in conjunction with intercurrent illness in patients with diabetes. This is a relatively uncommon presentation that can go unrecognized. Canagliflozin belongs to the class of sodium–glucose cotransporter 2 (SGLT2) inhibitors and is used for the management of type 2 diabetes. These agents lower blood glucose levels by selectively inhibiting SGLT2 cotransporters expressed in the proximal convoluted tubule of the kidney. Adverse effects include urinary tract infections, genital fungal infections (2), electrolyte abnormality, and DKA (3). During the recovery phase of DKA, hypophosphatemia can develop as a life-threatening condition. However, it is uncommon to have a phosphate level as low as <1 mg/dL (normal range 2.5–5 mg/dL). Herein, we describe the case of a patient with type 2 diabetes who presented with euglycemic DKA within 2 months of starting canagliflozin/metformin therapy. She had severe hypophosphatemia with phosphate levels <1 mg/dL during the recovery phase, requiring repletion of phosphate. A 32-year-old woman with a history of type 2 diabetes presented to the emergency room with a 1-week history of nausea and intractable emesis. Two months earlier, she had started on combination therapy with canagliflozin and metformin. On admission, her laboratory test results were as follows: blood glucose level of 277 mg/dL, anion gap of 19 mmol/L, bicarbonate of 8 mmol/L, serum pH of 7.22, creatinine of 0.81 mg/dL, potassium of 4.4 mEq/L, corrected serum sodium of 129 mmol/L, and positive serum and urine ketones. A diagnosis of euglycemic DKA was made. …
Vision-based model predictive control for within-hand precision manipulation with underactuated grippers

Precision manipulation with underactuated hands is a challenging problem due to difficulties in obtaining precise gripper, object and contact models. Using vision feedback provides a degree of robustness to modeling inaccuracies, but conventional visual servoing schemes may suffer from performance degradation if inaccuracies are large and/or unmodeled phenomena (e.g. friction) have significant effect on the system. In this paper, we propose the use of Model Predictive Control (MPC) framework within a visual servoing scheme to achieve high performance precision manipulation even with very rough models of the manipulation process. With experiments using step and periodic reference signals (in total 204 experiments), we show that the utilization of MPC provides superior performance in terms of accuracy and efficiency comparing to the conventional visual servoing methods.
How to Access Students’s Readiness for the Next Class

How many points should we allocate to different assignments and tests? to different problems on a test? Usually, professors use subjective judgment to allocate points. In this chapter, for classes which are pre-requisites for others, we provide an objective procedure for allocating points.
Short-Wavelength Content of LED Headlamps and Discomfort Glare

AbstractThis study evaluated the effect of short-wavelength content of headlamps on discomfort glare, in order to provide guidance regarding spectral compositions that would minimize driver complaints. Three light-emitting diode (LED) headlamps were tested (with correlated color temperatures of 4000, 4800, and 6600 K), as well as a tungsten-halogen headlamp and a high-intensity discharge (HID) headlamp. Subjects, seated in a stationary vehicle, rated discomfort from brief presentations of stimuli that produced illuminances of 0.25, 0.5, and 1 lx.As predicted in our previous analytical study, we found that—when they appear bluer than current tungsten-halogen or HID headlamps—LED headlamps tend to produce more discomfort glare. The effect is probably due to the color appearance of the LED lamps used in this study rather than to any inherent characteristic of LED sources, and it could probably be altered or reversed with different sources. For the data reported here, ratings of discomfort glare were linearly...
Saline and Soda Lakes

Saline lakes occur on all continents in hydrologically closed basins where evaporation exceeds local precipitation. Lakes with salinities above 3 g l−1 are usually considered saline, and the volume of water in saline lakes is about 80% as large as that in freshwater lakes. A considerable diversity of halophilic microorganisms with representatives from the three domains of life, the Archaea, Bacteria, and Eukarya, inhabit saline lakes. As salinity increases in inland waters, biodiversity tends to decrease, but in the mid-range of salinities other factors cause considerable variation in species diversity. Modest changes in the salinity and vertical distribution of salinity can have major impacts on trophic structure and nutritional status of these lakes. Examples of ecological changes as a function of salinity changes are provided for eastern African soda lakes, Mono Lake (USA), and the Dead Sea.
Period and Place, Capitalist Development, and the Flexible Specialization Debate

This chapter concerns the way in which we use concepts of period and place in social theory. It is prompted by thoughts raised in the context of the debate about flexible accumulation (FA) and flexible specialization (FS). The idea of industrial divides—whether that first promulgated by Piore and Sabel (1984) between mass production and a more recent revamped craft production or the military-industrial divide of Markusen (1991)—serve to emphasize the issue of periodization in social theory. The attendant concern with industrial districts of the sort first identified by Piore and Sabel brings to mind the issue of just how and why we might divide up substantive domains geographically. Some of the critique of flexible accumulation and flexible specialization theses has also served to draw attention to differentiation in the geographic plane: concerns for the institutional distinctiveness of Japan come to mind here (Kenney and Florida, 1988; Sayer, 1989; Curry, 1993).
Maximum Power Efficiency Tracking for UWPT

In this chapter, an adaptive control strategy called maximum power efficiency tracking (MPET) is presented. MPET improves the efficiency of the UWPT system without any direct output feedback. Usually, a wireless communication system is often required to send output power feedback signal to the input circuit. However, such feedback will require wired or Wi-Fi communication which is not viable in an underwater water environment. In the presented control method, the control is deployed on the secondary side of the system using a DC/DC converter.
Electrical properties and transmitter output associated with growth and transformation in shrimp muscle fibers

Comparisons were made of the passive electrical properties of closer muscle fibers in the dimorphic claws of snapping shrimp,Alpheus armillatus. During claw transformation the small fibers of pincer claws grow to become much larger snapper claw fibers. As muscle fibers grow, the relationship of fiber input resistance (R0) to fiber diameter (d) is predicted by the proportionality,R0∝d−3/2. Muscle fiber membrane resistance,Rm, is independent of fiber diameter, but membrane capacitance,Cm, grows with diameter. This results in a 40 to 50 fold reduction in fiber input impedance as fiber diameter enlarges during transformation. Reductions of muscle fiber impedance are partially compensated by 2–5 fold increases in quantal content at excitatory synapses on snapper muscle fibers. However, changes in quantal content during transformation apparently are independent of fiber diameter per se. Excitatory junction potentials in both pincer and snapper muscle fibers have equal amplitude. Because fiber input impedance decreases precipitously during transformation, and in view of the relatively small compensatory changes in quantal content at excitatory synapses, additional pre- or post-synaptic modifications must supplement increased quantal content to maintain synaptic efficacy in transformed muscle fibers.
Engaging with China

Recently, whether in Japan or abroad, I am often asked, “Where are you living now?” The answer is that half the time I live in the U.S., a little less than half in Japan, and the other month or so I travel to China or Europe. Having retired from my chaired professorship at Stanford University three years ago, I became a senior fellow at the Institute for International Studies. I am also visiting professor at the Graduate School of International Corporate Strategy at Hitotsubashi University, through the introduction by Professors Hirotaka Takeuchi and Ikujirō Nonaka. From April 2007, responding to the leadership of Chair Hideki Katō, I am participating as distinguished fellow at Tokyo Foundation.
Rapid expansion of mesenchymal stem/stromal cells using optimized media supplemented with human platelet lysate PLTMax® or PLTGold®, suitable for cGMP expansion at large scale.

Background & Aim Mesenchymal Stem/Stromal Cells (MSCs) are a promising candidate for tissue engineering and regenerative medicine applications due to their capacity of self-renewal and multilineage differentiation, ease of isolation and ability to grow in vitro. They are currently being used in hundreds of clinical trials and have been safely administered to thousands of patients with an expanding body of evidence of therapeutic efficacy. Mill Creek Life Sciences’ PLTMax®, derived from normal human donor platelets, arose as an alternative to FBS to be used as a supplement for in vitro expansion of human cells used in clinical applications. It is the only media supplement to date demonstrating clinical cultures of MSCs with long term genetic fidelity, rapid expansion and potent clinical activity. PLTMax® is being used worldwide in over 30 clinical trials including Phase I, II and III. Our latest product PLTGold®, is a second-generation human platelet lysate that does not require the addition of heparin to remain clot free, thus providing a fully xenogeneic free alternative supplement. Methods, Results & Conclusion In traditional monolayer expansion systems, we have demonstrated growth of adipose derived and bone marrow derived MSCs using an optimized, fully cGMP compliant culture system. We have found that MSC NutriStem® XF Basal Medium (Biological Industries USA, Inc, Cromwell, CT) supplemented with PLTMax® or PLTGold® exceeds the performance of other conventional media products, obtaining up to 5 × 108 cells in only 5 passages (5 times more cells than with other commercially available products). Furthermore, when we use MSC NutriStem® XF Complete Medium supplemented with PLTMax® or PLTGold®, we obtained up to 2 × 1010 cells in only 5 passages (200 times more cells than with other commercially available products). Cells grown in these media maintained MSC phenotype and capacity to undergo differentiation. The effective transfer into the clinic of allogeneic cell therapies using MSCs will depend predominantly on the development of large scale and cost effective manufacturing platforms that allow production of functional cells at the scale required to meet clinical demand. We also present the extension of these studies using this optimized method to evaluate 9 different microcarriers. Together, we will present an optimized protocol for the establishment of large scale expansion of MSCs in bioreactors.
P040 Monitoring defibrotide usage in paediatric patients undergoing HSCT with known risk factors for developing VOD/SOS

Aim Defibrotide is licensed for the treatment of hepatic venous occlusive disease (VOD) following haematopoeitic stem cell transplant (HSCT). Up to April 2015 defibrotide was used as prophylaxis against VOD in our HSCT patients who were considered at high-risk for developing VOD. This practice was discontinued due to the lack of evidence of efficacy and increasing costs of the drug. The aims of this audit were to identify patients undergoing HSCT who had one or more risk factors for the development of VOD, to measure the incidence of VOD in this patient cohort after the discontinuation of prophylactic defibrotide and calculate the cost savings associated with the discontinuation of prophylaxis. Methods All patients who underwent HSCT between Oct 2015 and Dec 2016 were included. Patient’s medical records were reviewed and risk factors for VOD were identified. Risk factors for developing VOD post HSCT in our patient cohort were defined following a literature review of peer-reviewed papers identifying paediatric specific risk factors.1 2 These were namely: patients aged ≤2 years, patients receiving a second transplant, conditioning with IV busulfan ± cyclophosphamide, and previous treatment with gemtuzumab ozogamicin. The theoretical dose of defibrotide for patients with known risk factors was calculated based on their weight at start of conditioning and the duration of treatment was based on the number of days conditioning the patient received plus 30 days following the date of transplant. The cost of a theoretical course of defibrotide for these patients was calculated to determine cost savings. Results Of the 27 patients included in the study, 16 (59%) had one or more risk factors. The most common risk factor identified was conditioning with busulfan in patients ≤2 years of age (26% of patients). At present no patient post HSCT has developed VOD requiring treatment. One patient developed sub-clinical VOD which required no treatment and resolved spontaneously. Another patient received defibrotide as prophylaxis for VOD due to severe liver dysfunction prior to HSCT. There were substantial cost savings following the discontinuation of prophylactic defibrotide with a total of 2876 vials (180 vials/patient) saved during this time period. Conclusion This audit validates our decision to discontinue use of prophylactic defibrotide and reserve its use for treatment of early VOD. References Cheuk D, Wang P, Lee T, Chiang A, Ha S, Lau Y, Chan G. Risk factors and mortality predictors of hepatic veno-occlusive disease after pediatric hematopoietic stem cell transplantation. Bone Marrow Transplantation. 2007;40:935–944. Mohty M, Malard F, Abecassis M, Aerts E, Alaskar A, Alijurf M, NiChonghaile M. Sinusoidal obstruction syndrome/veno- occlusive disease: current situation and perspectives- a position statement from the European Society for Blood and Marrow Transplantation (EBMT). 2015; Bone Marrow Transplantation. 2015;50:781–789.
Number of Siblings in Childhood, Social Outcomes in Adulthood:

In many parts of the world, fertility has declined in important ways in the past century. What are the consequences of this demographic change? Our study expands the empirical basis for understandi...
Impact of a Pharmacy Student Organization on the Admissions Experience and Student Professional Development

Objective. To evaluate the impact of a program which integrated student pharmacists into the admissions process on pharmacy school candidates' perceptions of the program and on participants' professional development. Methods. An anonymous survey regarding the pharmacy school admission process was sent to candidates following their visit to campus and interviews from fall 2014 through spring 2017. A second survey of all student pharmacists enrolled in January 2018 was conducted to assess the impact of a student-led organization, Pharmacy Student Ambassadors (PSA), on their professional development. Results. The response rate for the survey completed by candidates was 66% (335/504) and the response rate for the survey completed by enrolled student pharmacists was 50% (166/330). Almost all of the candidates were satisfied with the admissions process (96%, 322/335). They cited the welcoming and friendly environment and opportunity to interact with student pharmacists as the best aspects of the admissions process. In the survey of enrolled students, the majority of PSA volunteers agreed or strongly agreed with statements regarding their organization's influence on professional development (76%), enhancing communication skills (77%), self-reflection (78%), and feeling respected and valued (73%). Furthermore, the majority of student pharmacists agreed or strongly agreed that participation in the PSA positively impacted their own admissions process (87%), made interviewees more at ease and comfortable (88%), increased their knowledge and understanding of the culture in the program (82% and 75% respectively), and influenced their personal decisions to attend the University of Michigan College of Pharmacy (63%). Conclusion. Student pharmacist involvement in the admissions process was correlated with pharmacy school candidate satisfaction and contributed to enrolled students' positive perceptions regarding their professional development.
Factors affecting readmission rates after pancreatectomy

Background Pancreatectomy is a complex operation with a historic readmission rate of approximately 20%. Hospital readmissions lead to increased patient and health system costs, morbidity, and mortality making them a topic of great interest. The objective of this study was to identify factors associated with readmission after pancreatectomy in order to target areas for improvement. Methods Pancreatectomy procedures for malignancy in adults from 2005 to 2011 were identified in the California State Inpatient Database. Descriptive analysis was conducted to evaluate the association between baseline variables and readmission status. Logistic regression models were developed to determine whether the bivariate associations identified persisted after adjusting for patient characteristics. Results Of the 4262 patients who underwent a pancreatectomy, 843 (19.8%) were readmitted within 30 days. Readmission rates by year did not vary over the study period. Results from multivariable analysis showed that males, Hispanics, Medicare recipients, patients with an initial length of stay >11 days, patients who were discharged to a skilled nursing facility, and those with chronic anemia were more likely to be readmitted compared to those without these characteristics. The majority of readmissions occurred within 15 days after discharge. Conclusions Readmissions after pancreatectomy are multifactorial. Preoperative optimization, minimizing postoperative complications, and assuring patients have been evaluated by a multidisciplinary team may reduce the readmission rate.
Prediction of Chronic Disease-Related Inpatient Prolonged Length of Stay Using Machine Learning Algorithms

Objectives The study aimed to develop and compare predictive models based on supervised machine learning algorithms for predicting the prolonged length of stay (LOS) of hospitalized patients diagnosed with five different chronic conditions. Methods An administrative claim dataset (2008-2012) of a regional network of nine hospitals in the Tampa Bay area, Florida, USA, was used to develop the prediction models. Features were extracted from the dataset using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. Five learning algorithms, namely, decision tree C5.0, linear support vector machine (LSVM), k-nearest neighbors, random forest, and multi-layered artificial neural networks, were used to build the model with semi-supervised anomaly detection and two feature selection methods. Issues with the unbalanced nature of the dataset were resolved using the Synthetic Minority Over-sampling Technique (SMOTE). Results LSVM with wrapper feature selection performed moderately well for all patient cohorts. Using SMOTE to counter data imbalances triggered a tradeoff between the model's sensitivity and specificity, which can be masked under a similar area under the curve. The proposed aggregate rank selection approach resulted in a balanced performing model compared to other criteria. Finally, factors such as comorbidity conditions, source of admission, and payer types were associated with the increased risk of a prolonged LOS. Conclusions Prolonged LOS is mostly associated with pre-intraoperative clinical and patient socioeconomic factors. Accurate patient identification with the risk of prolonged LOS using the selected model can provide hospitals a better tool for planning early discharge and resource allocation, thus reducing avoidable hospitalization costs.
Specialized Regional Conferences Support the Professional Development Needs of Subject Librarians: A 5-Year Analysis of the Great Lakes Science Boot Camps for Librarians

Conference attendance can play an important role in supporting the professional development of subject librarians by offering opportunities that allow librarians to learn about new services, strategies, and technologies while growing and maintaining professional networks. However, barriers such as accessibility challenges, budgetary and resource restrictions, difficulty measuring learning gains, and difficulty measuring the value of professional development when applied to the job can restrict opportunities for many librarians. Specialized regional conferences have the potential to reduce many of these barriers. How can librarians, library administrators, and conference organizers quantify the value of regional conference attendance as an accessible means for fostering librarian professional development? This paper examines five years of assessment data and participant feedback from attendees of a specialized regional conference for STEM librarians and measures participant learning and participant motivation for conference attendance. We propose specialized regional conferences, such as the Great Lakes Science Boot Camp for Librarians, as accessible and affordable continuing education opportunities that support the professional development of subject librarians.
Skin Burns of the Head and Neck

Burns of the face and neck are devastating injuries with significant psychological and functional morbidity. A detailed understanding of the severity of head and neck burns is key to effective acute management of these injuries and prevention of long-term complications. This article focuses on acute management of burns of the face and skin both in the inpatient setting and managing the sequelae of facial burns including hypertrophic scarring, contractures, and functional issues such as microstomia and ectropion.
High titers of myelin oligodendrocyte glycoprotein antibody are only observed close to clinical events in pediatrics.

BACKGROUND Myelin oligodendrocyte glycoprotein (MOG)-IgG is increasingly detected in children with CNS demyelinating diseases. Due to the clinical overlap in children with CNS demyelination with and without MOG-IgG positivity, identifying distinct characteristics would help early diagnosis. OBJECTIVE To compare the specific features that may help differentiate MOG-IgG positive from negative children with CNS demyelinating diseases. To compare characteristics of patients with high and low MOG-IgG titers. METHODS Children with CNS demyelinating disorders with onset before 18 years of age who were tested for MOG-IgG at the University of California San Francisco were included. This retrospective study collected the following by chart review: demographic, clinical, MRI, CSF, and treatment data. Serum was tested for MOG-IgG at Mayo Clinic by live cell-based fluorescent activated cell sorting assay with titer ≥1:20 confirming positivity. RESULTS We assessed 65 Mog-IgG positive and 65 MOG-IgG negative patients. Median (IQR) age of onset was 7.6 (6.6) years for MOG-IgG positive and 13.8 (5.8) years for MOG-IgG negative (p<0.001). The female to male ratio was approximately 1:1 for the MOG-IgG positive group and 3:1 for the negative group (p=0.042). The most common initial diagnosis was demyelinating disease not otherwise specified (52.3%) in the positive group, compared to relapsing-remitting multiple sclerosis (41.5%) in the negative group (p<0.01). Optic nerve involvement (52.3%) was the most common clinical localization at onset for the MOG-IgG positive group, while brainstem/cerebellar (49.2%) localization predominated in the MOG-IgG negative group. The positive group also presented more often with a severe event at disease onset than the negative group (81.5% vs 60.3%; p< 0.002). MOG-IgG positive children had a lower frequency of oligoclonal bands (15.8% vs 57.4%; p<0.001). The frequency of baseline brain and spinal cord MRI abnormalities were similar in both groups; however, MOG-IgG positive patients more often had T2 hyperintense lesions in the optic nerves (26/43 vs 10/41; p<0.001). Disease-modifying medications were used in 64.6% of MOG-IgG positive patients versus 80% of negative children. Of the 32 positive patients with follow-up titers, seven reverted to negative while two who tested negative initially converted to positive. Positive titers greater than 1:160 were only observed within four months of a clinical event (disease onset or relapse). Patients with high and low MOG-IgG titers were comparable in demographic and clinical characteristics. CONCLUSION Despite some clinical overlap, we report notable demographic, MRI and CSF differences between MOG-IgG positive and negative children with CNS demyelinating disorders at disease onset. High MOG-IgG titers were only observed close to a clinical event.
Differences in abortion-related knowledge among women involved in the criminal legal system in three US cities.

Abstract Objective We examined if abortion-related knowledge among women with criminal legal system involvement differed in three U.S. cities in states with varying abortion policies. Study Design Respondents were self-identified women with criminal legal system involvement. Data come from a cross-sectional baseline survey of 381 women in three U.S. cities: Oakland, California, Kansas City, Kansas/Missouri, and Birmingham, Alabama. The primary outcome, high abortion-related knowledge, was based on a 10-item scale dichotomized into low vs high abortion-related knowledge. We used descriptive statistics, bivariable associations, and logistic regression to assess the association between high abortion-related knowledge, city of residence, and other possible related factors. Results Respondents in Kansas City, KS/MO and Birmingham, AL had lower odds of high abortion-related knowledge compared to respondents in Oakland, CA (OR: 0.19, 95% CI: 0.10–0.38 and OR: 0.17, 95% CI: 0.11–0.28, respectively). In adjusted analysis, the association remained after controlling for race/ethnicity, insurance status, and community supervision past year. Conclusions Findings underscore the need for communicating clear and accurate information about abortion care, especially in states where laws and ongoing political challenges make it difficult to access both reliable information and services. Implications Efforts to disseminate accurate information regarding abortion care, particularly among marginalized people, should utilize multiple venues in addition to traditional healthcare information sources. Reproductive justice advocates should connect with jails and probation offices to reach people with criminal legal system involvement and foster increased knowledge of reproductive rights and services.
Analysis and Solution of the Current Situation of Local Communication in the Power Distribution Area

This paper analyzes the problems of node cross-registration, manufacturer interconnection and communication port configuration in the process of diversified access of various data in the power distribution area. These problems have affected the transmission efficiency of the existing electricity consumption information collection system, and urgently need to be solved. In this paper, a variety of communication technologies are compared and analyzed, IP-based HPLC technology is applied, and other communication methods are combined to finally provide a local communication solution for the power distribution network area.
Internet Appendix for CEO Employee Approval and Firm Value: Evidence From Employees' Choice Awards

This file provides additional robustness checks for CEO Employee Approval and Firm Value: Evidence from Employees' Choice Awards. Section one describes sample construction for samples not in the data section of the paper. Section two provides the results of the additional tests. Section three includes the figures and tables for the internet appendix.
Gravity Probe B Data Analysis: Status and Potential for Improved Accuracy of Scientific Results

This is the first of five connected papers detailing progress on the Gravity Probe B (GP-B) Relativity Mission. GP-B, launched 20 April 2004, is a landmark physics experiment in space to test two fundamental predictions of Einstein’s general relativity theory, the geodetic and frame-dragging effects, by means of cryogenic gyroscopes in Earth orbit. Data collection began 28 August 2004 and science operations were completed 29 September 2005. The data analysis has proven deeper than expected as a result of two mutually reinforcing complications in gyroscope performance: (1) a changing polhode path affecting the calibration of the gyroscope scale factor C g against the aberration of starlight and (2) two larger than expected manifestations of a Newtonian gyro torque due to patch potentials on the rotor and housing. In earlier papers, we reported two methods, ‘geometric’ and ‘algebraic’, for identifying and removing the first Newtonian effect (‘misalignment torque’), and also a preliminary method of treating the second (‘roll-polhode resonance torque’). Central to the progress in both torque modeling and C g determination has been an extended effort on “Trapped Flux Mapping” commenced in November 2006. A turning point came in August 2008 when it became possible to include a detailed history of the resonance torques into the computation. The East-West (frame-dragging) effect is now plainly visible in the processed data. The current statistical uncertainty from an analysis of 155 days of data is 5.4 marc-s/yr (∼14% of the predicted effect), though it must be emphasized that this is a preliminary result requiring rigorous investigation of systematics by methods discussed in the accompanying paper by Muhlfelder et al. A covariance analysis incorporating models of the patch effect torques indicates that a 3–5% determination of frame-dragging is possible with more complete, computationally intensive data analysis.
On Judicial Discretion in Statutory Interpretation

In most cases it is realistic to suppose that statutes have a precise, judicially determinable meaning and that the courts are in a position to discover and declare that meaning through a process of legal reasoning. Yet there are cases in which this concept is simply unworkable. Not every question of statutory interpretation can be resolved persuasively through a process of legal reasoning, and to pretend otherwise is to perpetuate a fiction. Some legal fictions are useful; this one is not. It degrades, confuses, and corrupts the interpretive process.Conventional interpretation is likely to fail in cases such as the ones I describe in this essay. Sometimes a conscientious judge will examine the relevant statute and conclude that more than one interpretation is possible and that conventional considerations do not favor a particular interpretive choice. In such a case, the judge should be free to declare that the statute creates a framework for choice, and the judge should be allowed to exercise prudent judgment within the statutory framework by preferring one permissible interpretation or another, while explaining candidly the reasons for the preference. In such a case the interpretive process is essentially a discretionary process, and it should be theorized as such.